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Tag: prescription opioids

  • Are American Drugmakers Pushing Pain Pills In India?

    Are American Drugmakers Pushing Pain Pills In India?

    “Painkillers are part of the daily routine. They have become more normalized,” says one social worker in India. 

    At home, major drug manufacturers like Purdue Pharma and Johnson & Johnson are facing declining sales and a plethora of lawsuits. Which is—at least in part—why they have turned their attention to India, a country with a growing middle class population and newly relaxed restrictions on opioid pain medications. 

    When Dr. GP Dureja founded the Delhi Pain Management Centre, people told him, “Nobody has time to complain about pain in our country.”

    Now, that mindset has changed, Dureja said. “I’m getting five to seven new patients per day,” he told The Guardian. 

    For decades, Indian law tightly controlled access to opioids, because the country historically had issues with opioid abuse.

    Normalization Of Opioids

    However, in recent years, in part due to lobbying by palliative care advocates, the regulations have been relaxed. Fentanyl and methadone are now readily available for pain relief and are beginning to be abused. 

    Alfiya Mulla, a social worker in India, said, “Painkillers are part of the daily routine. They have become more normalized.”

    American companies are moving in to profit from the change. Mundipharma, controlled by the Sackler family, sells buprenorphine in India, while Johnson & Johnson sells fentanyl patches. 

    Indians—like Americans of the early 2000s—see pain relief as a right. 

    Dr. Dureja summed up the changing mindset: “Don’t listen to your forefathers. They said you should tolerate pain, you should not complain, you should not take painkillers. Now, everybody wants to get rid of pain early.”

    Public health expert Dr. Bobby John is concerned that with public opinion on their side, drug companies will find ways to flood India with opioids. “Are people going to figure out every trick in the game to make [opioid painkillers] widely available? Of course it will happen,” he said. 

    Although Dr. Dureja works in pain medicine, even he is concerned by the proliferation of opioids. “General practitioners have started prescribing these drugs, and we’re not educating the population on when to use and not to use,” he said. 

    Opiophobia

    Yet, people who are in favor of expanded access to opioids argue that reducing regulations is important to providing palliative and end-of-life care to Indians who are living—and dying—with chronic pain. 

    “This is a rather horrible country to die in,” said Dr. MR Rajagopal, an Indian physician who speaks out against what he sees as “opiophobia.”

    Rajagopal shared the story of one patient with lung cancer, who came to get morphine tablets. Rajagopal’s clinic was out of the medication. 

    The patient “told us with outward calm, ‘I shall come again next Wednesday. I will bring a piece of rope with me. If the tablets are still not here, I am going to hang myself from that tree,’” Rajagopal said. “He pointed to the window. I believed he meant what he said.”

    View the original article at thefix.com

  • Discontinuing Opioids Too Quickly Can Be Harmful, FDA Warns

    Discontinuing Opioids Too Quickly Can Be Harmful, FDA Warns

    The FDA issued guidance to help address the issue of opioid-dependent patients discontinuing or tapering off too quickly and becoming sick. 

    Since the national crackdown on prescription opioids, many pain patients have been forced to taper their dose of painkillers. Now, the Food and Drug Administration is warning doctors that tapering too quickly can have unintended and dangerous consequences. 

    “The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased,” the agency said in a statement. “These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.”

    The FDA issued guidance to help address the problem. 

    “These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued,” the agency wrote. 

    The agency said that providers should make an individualized plan for patients who need to taper off opioids, and should never stop the pain pills suddenly. The plan should take into consideration the type of opioid and dosage, as well as the patient’s pain and psychological concerns. 

    “Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress,” the FDA wrote. 

    The agency also warned that patients should not discontinue opioids without talking to their providers. They should be candid about any side effects they have as their dose of opioids is being tapered. 

    “Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal,” the agency warned. “Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.”

    Although many public health officials applaud efforts to reduce the amount of opioids prescribed, pain patients say that the regulations have gone too far, and have left vulnerable pain patients unprotected. 

    Speaking with The Fix last fall, Lauren DeLuca, a pain patient and founder of the Chronic Illness Advocacy and Awareness Group, said that not being able to access pain medications can be devastating for patients. She said she regularly hears from pain patients who are not able to access enough medications to alleviate their symptoms. Sometimes, these people begin to consider suicide.

    “It is borderline genocide,” she said. “You are allowing them to go home and essentially suffer until they kill themselves.”

    View the original article at thefix.com

  • New York Tries To Tax Prescription Opioids Again

    New York Tries To Tax Prescription Opioids Again

    Some people argue that the tax could push people to use illegal alternatives if prescription opioids become more expensive.

    New York state has passed a measure to tax opioid prescriptions in an attempt to fund addiction-recovery efforts, despite the fact that a court ruled a similar measure unconstitutional last year. 

    According to WXXI, the state said that the measure, part of the state budget, is intended to raise additional funds to pay for the response to the opioid crisis by taxing manufacturers.

    However, some people argue that the tax could have unintended effects, pushing people to use illegal substances if prescription opioids become more expensive. 

    “While the language of the proposed law attempts to place the burden of the tax on drug manufacturers, in practice market forces determine how the burden of the tax is shared between producers and consumers,” Lewis Davis, professor of economics at Union College, wrote in a report.

    The report was prepared last year and paid for by a pharmaceutical lobbying group, but echoed concerns shared by other organizations including the American Cancer Society Action Network.

    Davis pointed out that the tax policy could have a number of negative side effects. 

    “Most of the tax will be paid by non-consuming NY residents in the form of higher insurance premiums and higher taxes to cover public health programs. Second, to the extent that the cost of the tax is passed on to consumers, it will have a high cost to society in terms of reduced access to medically appropriate use of opioids,” he wrote. “Third, by increasing the cost of prescription opioids, the proposed tax will encourage NY residents suffering from opioid dependence to switch to cheaper illegal opioids, including heroin and fentanyl, with increased rates of accidental overdose.”

    He continued, “Because it fails to target opioid abuse, the proposed tax is poorly designed policy for addressing the opioid crisis.”

    Last year, a federal court struck down the tax because it would violate interstate commerce laws by treating New York residents differently from consumers in other states. The 2019 version of the bill works around that and should stand up in court, according to the state. 

    Freeman Klopott, a spokesperson for the state budget office, said that New Yorkers who use prescription opioids won’t be affected by the measure, since most of the cost for the tax will be shouldered by insurance companies and drug manufacturers. 

    “We expect no significant change in the availability of these pharmaceuticals or any diversion to illicit alternatives,” said Klopott.

    View the original article at thefix.com

  • Doctors Are Cutting Back On Prescribing Opioids

    Doctors Are Cutting Back On Prescribing Opioids

    The number of doctors starting patients on opioid prescriptions also significantly declined.

    While overdose-related deaths from prescription opioids have more than quintupled over the past two decades, some encouraging news regarding the number of new opioid prescriptions written during a portion of that period has surfaced in a new study.

    Time cited research that examined national claims data culled from Blue Cross Blue Shield, which showed that the number of new opioid prescriptions issued per month dropped by 54% between 2012 and 2017—while the number of doctors issuing opioid prescriptions to patients for the first time also declined by a significant number.

    But as the study authors noted, these lower numbers were tempered by the number of physicians who continued to prescribe opioids during this time period, which was often at higher doses and for longer periods of time than the recommended limits suggested for first-time patients by the Centers for Disease Control and Prevention (CDC) in 2016.

    Those guidelines served as the focal point for the study, which was conducted by researchers from Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital’s Department of Medicine, and published in the New England Journal of Medicine.

    Issued as the opioid epidemic began to reach critical numbers across the country, the CDC urged physicians to either abstain from using opioids as the first course of pain treatment, or to issue three-day supplies of opioid prescriptions at the lowest dose to first-time patients. 

    From there, researchers focused on the monthly incidence of new opioid prescriptions, which they determined was the percentage of Blue Cross Blue Shield members who were receiving an opioid prescription for either the first time ever, or for the first time in the previous six months.

    Their review of the data found that the number of new prescriptions dropped by more than half between 2012 and 2017, while the number of doctors prescribing opioids—either for the first time or to those who hadn’t received a prescription in the previous six months—declined from 114,043 to 80,462.

    “On one hand, we are very much encouraged,” said Nicole Maestas, an associate professor at Harvard Medical School and co-author of the study, to Time. “The study does suggest that every month, fewer people are being started on opioids, which means that the risk of developing opioid addictions and other adverse outcomes is lower because of that. Our enthusiasm is a bit tempered, however. One group of providers didn’t seem to get the message.”

    Maestas was referring to doctors who continued to prescribe opioids after the CDC issued the guidelines. Among that group, they found that 57% were prescribing them to first-time patients for longer than the three-day recommended period, and at higher doses. Of that group, 80% were primary care doctors in private practice.

    The study also raised another area of concern for Maestas and her team—it highlighted the possibility that doctors were not prescribing opioids for patients whose level of pain required such drugs. About 30% of the doctors whose prescriptions were included in the study time period did not prescribe opioids at all to people who had not used them.

    As Time noted, the authors were not able to determine if those patients were given other options for pain management, and suggested that in some cases, pain was under-managed rather than over-prescribed.

    Ultimately, the researchers hope that their findings will help hone future prescription guidelines.

    “It’s good news that some providers are changing their behavior, but not all providers are,” said Maestas. “The data suggests that some could use additional education around this issue.”

    View the original article at thefix.com

  • Former Commissioner Blames FDA For Opioid Crisis: "No One Stopped It"

    Former Commissioner Blames FDA For Opioid Crisis: "No One Stopped It"

    “There are no studies on the safety or efficacy of opioids for long-term use,” said former FDA commissioner David Kessler in a recent “60 Minutes” interview.

    The former Food and Drug Administration commissioner expressed regret that the agency allowed drug companies to promote the idea that opioid painkillers were safe for long-term use in a recent 60 Minutes interview.

    Dr. David Kessler was FDA commissioner during the ’90s, when Purdue Pharma’s prescription opioid OxyContin was approved. Shortly after, Purdue began an aggressive marketing campaign to both prescribers and consumers, including chronic pain patients. 

    In 2001, the FDA changed the indication on the label for prescription opioids to say that it was safe for long-term use, allowing drug companies to market them as such. However, Dr. Kessler now says that there were no studies on the long-term effects of regular, ongoing opioid use at the time.

    “There are no studies on the safety or efficacy of opioids for long-term use,” said Kessler in the interview. “The rigorous kind of scientific research the agency should be relying on is not there.”

    The former commissioner also appears to regret allowing the methods of the OxyContin marketing campaign, which were unprecedented in the prescription drug market. Soon, companies like Purdue were convincing doctors to prescribe more pills at higher doses — something that experts believe fueled the current epidemic of opioid-related addiction and overdoses.

    Dr. Kessler is now on retainer by cities and counties that are suing Perdue Pharma and other drug companies for the damage caused by the opioid crisis. He officially left the FDA before the drugs were proclaimed safe for extended use, but laments that no one stopped it from happening.

    “You have a system of pharmaceutical promotion that changed the way medicine practiced and no one, all right, stopped it,” he said. He later blames this on understaffing in the FDA marketing department.

    Current FDA Commissioner Dr. Scott Gottlieb declined to be interviewed, instead providing a written statement.

    “Many mistakes were made along the way,” it reads. “While the agency followed the law in approving and regulating opioids, we at the FDA include ourselves among those that should have acted sooner.”

    On another 60 Minutes segment three days later, drug manufacturer Ed Thompson indicted “his own industry” and agreed with Dr. Kessler’s assessment that the label change was what sparked the opioid epidemic.

    “The root cause of this epidemic is the FDA’s illegal approval of opioids for the treatment of chronic pain,” Thompson said. “Without question, they start the fire.”

    Thompson himself is now suing the FDA in an attempt to force the administration to change the label on prescription opioids once again to say that it’s only safe for short-term use. As a maker of these drugs, he stands to lose billions if he’s successful. Thompson is going ahead with the suit, however, refusing to sell what he calls “snake oil” to consumers.

    “You’re using high-dose, long-duration opioids when they’ve never been designed to do that,” he explained to the 60 Minutes host. “There’s no evidence that they’re effective. There’s extreme evidence of harms and deaths when you use them.”

    View the original article at thefix.com

  • Driving While On Prescription Opioids Can Be Deadly

    Driving While On Prescription Opioids Can Be Deadly

    Researchers have uncovered an alarming trend among drivers under the influence of prescription opioids.

    As the opioid epidemic continues to grow, the medications are being blamed for more fatalities on the road. 

    In the past 25 years, according to U.S. News & World Report, the number of fatal car crashes with drivers high on opioids has tripled. 

    These results come from a study which examined more than 18,000 fatal car crashes involving two vehicles in the U.S. from 1993 to 2016. Of those, more than half (55%) of driving errors made by drivers who later tested positive for prescription opioids had to do with the driver not staying in their own lane.  

    According to study co-author Dr. Guohua Li, who is also the director of the Center for Injury Epidemiology and Prevention at Columbia University Medical Center, the failure to stay in one’s lane was “a particularly dangerous driving error.” 

    In fact, researchers found that this error was a factor in more than 40% of fatal crashes involving two vehicles, “making it the most common cause of deadly auto accidents.”

    According to Li, the outcome of the study “adds important information for understanding the ripple effects of the opioid epidemic, particularly its adverse effect on driving safety.”

    Li adds that prescription opioids “are potent pain medications that can cause drowsiness, nausea, and impaired cognitive functions and psychomotor skills, including reduced reaction time, alertness, attention and concentration.”

    When it comes to how opioids impact drivers in comparison to alcohol, Li says that the effect of driving on opioids is about equal to having a blood alcohol concentration of 0.05%. This falls just under 0.08%, which is what most states consider driving under the influence, according to U.S. News and World Report. 

    According to Li, testing a driver for opioids is more expensive and more difficult than testing for alcohol. “It is also more difficult to detect drug-impaired driving than alcohol-impaired driving through field sobriety tests,” he said. 

    “But law enforcement is making effort to tackle the drugged driving problem,” he added. “For example, many states are expanding their drug recognition expert programs, which would train more police to become certified field evaluators of driving under the influence of drugs.”

    JT Griffin, chief government affairs officer for Mothers Against Drunk Driving, tells U.S. News that the results of the study are not surprising. “With the rising use of opioids, it is not surprising that there is an increase in the number of drivers with opioids in their systems,” he said.

    “Any drug that causes drowsiness, slows reaction times, or affects judgment and mobility in any way is a threat to public safety,” Griffin added. “It’s important that people do not drive anytime they are drinking or using any kind of impairing substance.”

    View the original article at thefix.com

  • Opioid Epidemic Will Get Worse, Researchers Say

    Opioid Epidemic Will Get Worse, Researchers Say

    Using computer modeling, researchers predicted that overdose deaths will kill 81 ,700 people in 2025 unless drastic changes are made.

    Researchers from Massachusetts General Hospital have grim news about the opioid epidemic: It’s likely to continue worsening in the coming years, unless widespread, drastic policy changes are taken to address illicit drug use. 

    The study, published in the journal JAMA Network Open, showed that even with efforts to more tightly control access to prescription opioids, overdose deaths will continue to rise.

    Using computer modeling, researchers predicted that overdose deaths will kill 81 ,700 people in 2025, most of whom will die from illicit opioids. Further restricting access to prescription opioids will only reduce that number by 3%-5.3%, researchers found. 

    “This study demonstrates that initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term,” Dr. Marc Larochelle of the Grayken Center for Addiction at Boston Medical Center said in a press release. “We need policy, public health and health care delivery efforts to amplify harm reduction efforts and access to evidence-based treatment.”

    Jagpreet Chhatwal, who co-authored the paper with Larochelle and others, said that more drastic measures are needed to target the use of illicit opioids. 

    “If we rely solely on controlling the supply of prescription opioids, we will fail miserably at stemming the opioid overdose crisis. Illicit opioids now cause the majority of overdose deaths, and such deaths are predicted to increase by 260%—from 19,000 to 68,000—between 2015 and 2025,” said Chhatwal. “A multi-pronged approach—including strategies to identify those with opioid use disorder, improved access to medications like methadone and buprenorphine, and expansion of harm reduction services such as the overdose-reversal drug naloxone—will be required to reduce the rate of opioid overdose deaths.” 

    Chhatwal said that while easy access to prescription opioids may have contributed to the crisis, today the epidemic is more about illicit opioids including fentanyl and its analogues. Because of this, efforts to reduce overdose deaths need to focus on addressing the population of people who are using illegal drugs. 

    “The opioid epidemic started with a sharp increase in opioid prescriptions for pain in the 1990s; but since 2010 the crisis has shifted, with a leveling off of deaths due to prescription opioid overdoses and an increase in overdose deaths due to heroin,” he said.

    “In the past five years, deaths have accelerated with the introduction of the powerful synthetic opioid fentanyl into the opioid supply, leading to a continuing increase in overdose deaths at time when the supply of prescription opioids is decreasing.”

    View the original article at thefix.com

  • FDA Issues Warning To Drug Manufacturer Over Product Tampering

    FDA Issues Warning To Drug Manufacturer Over Product Tampering

    McKesson is the first drug manufacturer to get a warning letter from the FDA about properly securing and tracking drug shipments.

    In 2016, three Rite Aid pharmacies reportedly unloaded what were supposed to be bottles of opioid pills, only to discover that the pills had been replaced with other medications such as Aleve.

    Now, partly because of those incidents, the Food and Drug Administration has issued a formal warning to the drug manufacturer McKesson for shipping “illegitimate” opioids and not properly tracking drug shipments. 

    “This is simply unacceptable,” FDA Commissioner Scott Gottlieb said in a statement. 

    Gottlieb said that the FDA has taken measures to curb the flow of illegal drugs into the country. However, the administration also relies on the cooperation of drug manufacturers to ensure the safety of prescription drugs. 

    “Just as critical are the FDA’s efforts to protect patients from exposure to drugs that get into the legitimate U.S. supply chain that may be counterfeit, stolen, contaminated or otherwise harmful, as well as making sure these same drugs aren’t being diverted for illegal sale,” Gottlieb wrote. “Entities within the supply chain must also comply with the law and do their part to respond quickly and thoroughly when notified of potential counterfeit, stolen or diverted products entering the supply chain.”

    Gottlieb said that the warning letter to McKesson is the first issued under the Drug Supply Chain Security Act. 

    “The warning letter to McKesson outlines violations observed during inspections that took place this past summer, including failing to: sufficiently respond to notifications that there was illegitimate product in their supply chain; quarantine and investigate suspect products; and maintain records of investigations of suspect product and disposition of illegitimate product as the law requires,” he wrote. 

    When one pharmacy received medications that had been tampered with, it alerted McKesson to the issue. The distributor launched an investigation, but the FDA said it was not thorough enough. 

    “While McKesson’s internal investigation noted that it was likely the opioid medication was replaced while in their possession or control, McKesson did not sufficiently respond to the notification that they may have distributed illegitimate products,” Gottlieb said. 

    According to CNBC News, McKesson is taking the warning “very seriously.” 

    The company said in a statement, “We have been in communication with the FDA over the past several months to respond to their questions and we are in the process of providing additional procedural detail and documentation, including enhancements recently made in response to the FDA’s initial feedback. We are committed to the security of the supply chain and are taking steps to help ensure we comply fully with FDA’s track-and-trace laws for all pharmaceutical products.”

    View the original article at thefix.com

  • Opioid Epidemic Will Get Worse, Researchers Says

    Opioid Epidemic Will Get Worse, Researchers Says

    Using computer modeling, researchers predicted that overdose deaths will kill 81 ,700 people in 2025 unless drastic changes are made.

    Researchers from Massachusetts General Hospital have grim news about the opioid epidemic: It’s likely to continue worsening in the coming years, unless widespread, drastic policy changes are taken to address illicit drug use. 

    The study, published in the journal JAMA Network Open, showed that even with efforts to more tightly control access to prescription opioids, overdose deaths will continue to rise.

    Using computer modeling, researchers predicted that overdose deaths will kill 81 ,700 people in 2025, most of whom will die from illicit opioids. Further restricting access to prescription opioids will only reduce that number by 3%-5.3%, researchers found. 

    “This study demonstrates that initiatives focused on the prescription opioid supply are insufficient to bend the curve of opioid overdose deaths in the short and medium term,” Dr. Marc Larochelle of the Grayken Center for Addiction at Boston Medical Center said in a press release. “We need policy, public health and health care delivery efforts to amplify harm reduction efforts and access to evidence-based treatment.”

    Jagpreet Chhatwal, who co-authored the paper with Larochelle and others, said that more drastic measures are needed to target the use of illicit opioids. 

    “If we rely solely on controlling the supply of prescription opioids, we will fail miserably at stemming the opioid overdose crisis. Illicit opioids now cause the majority of overdose deaths, and such deaths are predicted to increase by 260%—from 19,000 to 68,000—between 2015 and 2025,” said Chhatwal. “A multi-pronged approach—including strategies to identify those with opioid use disorder, improved access to medications like methadone and buprenorphine, and expansion of harm reduction services such as the overdose-reversal drug naloxone—will be required to reduce the rate of opioid overdose deaths.” 

    Chhatwal said that while easy access to prescription opioids may have contributed to the crisis, today the epidemic is more about illicit opioids including fentanyl and its analogues. Because of this, efforts to reduce overdose deaths need to focus on addressing the population of people who are using illegal drugs. 

    “The opioid epidemic started with a sharp increase in opioid prescriptions for pain in the 1990s; but since 2010 the crisis has shifted, with a leveling off of deaths due to prescription opioid overdoses and an increase in overdose deaths due to heroin,” he said.

    “In the past five years, deaths have accelerated with the introduction of the powerful synthetic opioid fentanyl into the opioid supply, leading to a continuing increase in overdose deaths at time when the supply of prescription opioids is decreasing.”

    View the original article at thefix.com

  • DEA, Drug Distributors Failed To Protect West Virginia, Report Says

    DEA, Drug Distributors Failed To Protect West Virginia, Report Says

    A new report highlighted the way millions of opioids flooded small towns in West Virginia over a 10-year-period with ineffective government oversight.

    Despite the fact that “inordinate volumes of opioids” were flowing into West Virginia between 2006 and 2015, drug distributors continued to fill outrageous orders, and the Drug Enforcement Administration took ineffective measures to enforce regulations that could have slowed the flow of opioids, according to a federal report released last week. 

    The report, “Red Flags and Warning Signs Ignored: Opioid Distribution and Enforcement Concerns in West Virginia,” was prepared by House Energy and Commerce Committee.

    It found that in 10 years, 20.8 million opioids were sent to pharmacies in the town of Williamson, which has a population of just 3,000. Another town, Kermit, which has a population of just 364 people, received 9 million. Overall, between 2007 and 2012, West Virginia pharmacies received more than 780 million hydrocodone and oxycodone pills.

    “These troubling examples raised serious questions about compliance with the Controlled Substances Act (CSA), administered by the Drug Enforcement Administration (DEA),” report authors wrote. 

    The report reviewed the practices of drug distributors, who are responsible for filling orders by pharmacies. Five companies, including the three largest in the country and two regional distributors, were reviewed. These were AmerisourceBergen Drug Corporation, Cardinal Health, Inc., H.D. Smith Wholesale Drug Co., McKesson Corporation, and Miami-Luken, Inc. 

    The companies have a legal obligation to alert the DEA when they suspected that drugs were being diverted into illegal use. However, case studies reviewed in the report “raise sufficient concerns as to whether these companies fulfilled their legal obligations to prevent drug diversion.”

    In fact, “the extraordinary volume of shipments in West Virginia was a signal of possible breakdowns in distributors’ oversight of their customers, including their suspicious order monitoring systems. Yet the actions taken by both distributors and the DEA contributed to — and failed to stop — this problem,” report authors wrote. 

    The report also found that the DEA’s Automation of Reports and Consolidated Orders System, which is meant to help detect abnormal drug distribution patterns in real time, was not used to monitor distribution, but only to reinforce cases after they’d been flagged through other means. Additionally, the agency revoked the registration of fewer doctors and pharmacies thought to be contributing to drug diversion during the height of the pill crisis. 

    Authors of the report said that the findings could help explain how the opioid epidemic unfolded across the nation. 

    “Taken altogether, the Committee’s report outlines a series of missteps and missed opportunities that contributed to the worsening of the opioid epidemic in West Virginia,” they wrote. “This investigation identified flaws limiting the effectiveness of the distributors’ compliance programs and DEA’s enforcement. While focused on a narrow part of West Virginia, the report raises grave concerns about practices by the distributors and the DEA nationwide.”

    View the original article at thefix.com