Purdue Targeted as Trump Declares Opioid Emergency (Audio)

Relief Fund. Trump's Presidential Commission on the crisis had recommended that action, and Trump indicated in August he would follow that recommendation. The opioid crisis is an emergency, and I'm saying officially right now it is an emergency. It's a national emergency. We're going to spend a lot of time, a lot of effort, and a lot of money on the opioid dressing. The public health emergency last ninety days and can be renewed indefinitely, joining us as Richard Austin

as a professor at the University of Kentucky School of Law. Richard, what's the result of this declaration of public health emergency? What happens next? Well, it's it's hard to say what ultimately will happen. It's a good first step. Uh, it comes a little late in the game. This has been going on for at least fifteen years, but it is nice that the federal government is finally taking it seriously. Richard. How much more would would be be done if the

President had gone further and declared a national emergency? Well, it sounds like the states would have been able to apply for money to help with opioid addiction, and certainly it's going to take a lot of money and a lot of time to uh make a dent in that in that problem, Richard. Would there be any downside to declaring a national emergency besides the amount of funding, Well, I don't see any downside it. I suppose you could. You could argue that it's not an emergency like a

flood or or an earthquake or something like that. You know that it's really a long term, very serious social problems. So it isn't the sort of thing that a few hundred million dollars at you know, at one fail swoop is going to help much. Well, let's talk a little bit about the things that actually will do. So, if I understand it correctly, we're talking about wider access to telemedicine services, UH, speeding up the hiring process to get more people in place who can you can deal with

this problem. Let's uh local governments repurpose some funds. UH. Which of those steps of any are gonna potentially have a significant dent in this problem? Well, probably none of them. None of them will have a significant UH dent or making a significant dent. I mean, the trouble is, they are millions of people who are addicted, and it's it's going to take a few huge commitment of resources to UH to deal with that problem. And I think it's probably beyond the capability of the states to do it,

at least by themselves. UH. You know. The trouble is that that we tend to attack problems of this sort piece meal. So, for example, a few years ago, it was shut down the pill mills UM and so a lot of effort was focused in that direction and was largely successful, but it didn't really cure the the overall problem.

People just turned to other drugs like heroin UH and UH and other sources of supply, and so the problem wasn't really alleviated very much, Richard, Because there have to be a comprehensive legislative package from Congress with a dedicated stream of funding, or are there other ways to approach this Well, I think that that would be a good idea, and perhaps it could be the foundation for an overall

comprehensive program. I mean, it can be totally federal, but whatever long term solution there is, it's going to require a lot of a lot of money. So the federal government certainly has an important role to play in that respect. Uh And of course uh uh, it can try to regulate the drug companies, who are at least a part of the source of the problem. Uh and uh for focus on them. That might help some too. But it's a very very complex problem, and there's probably no one

particular thing that's going to be the solution. It's going to be a multitude of of of efforts. Uh and and and it's going to be a long term project as well. Richard, Don't we only have got a minute left right right now, But you mentioned that that taking the federal government a long time to get to this point. It's been going on for fifteen years. Should we be casting blame not just at at the Trump administration, but

at the Obama administration not moving more quickly on this. Well, I think, I mean, there's certain parts of the federal government, the UM certain U. S. Attorneys have been pretty aggressive in going after the drug companies, bringing criminal proceedings against them.

Uh So it's not that the government hasn't done anything, but it's sort of sad and ironic that Congress just, uh not just but several months ago pasted legislation that greatly reduced the drug the as enforcement powers against drug companies, and it was passed unanimously, I might add, uh and promptly signed by the president was President Obama at the time. So they seemed to, uh go, they seem to be

ambivalent about how they want to approach the problem. President Trump is going to declare widespread opioid abuse the public health emergency today, but there's also a wave of government lawsuits where states, counties, and cities have sued opioid makers

and distributors. There's all so a federal criminal investigation and to produe farmers marketing of the opioid pain killer OxyContin, and Insist Therapeutics founder John Kapoor and six other former executives have been charged with conspiracy to him at fraud by bribing doctors to prescribe the company's opioid pain drug. Our guests are Richard Austiness, professor at the University of Kentucky Law School, and Leo Belotowski, professor at Northeastern University

Law School. Leo, let's start with the government lawsuits. What's the legal basis of the suits? Well, there's a number of legal theories, um, you know, basically fraudalent marketing, and a lot of consumer protection rules that are alleged to be violated. Um. And you know, in many ways, these lawsuits, in my view, are you know, somewhat late to the

late to the punch, um. You know. The From a public health perspective, the crisis now is driven non by pharmaceutical drugs, and although certainly industry practices deserve a lot of scrutiny, um, you know, I doubt that these lawsuits will make much of a doe in the current crisis as it exists today. Richard, let me ask you about

this criminal investigation into Perdue Pharma. What do we know based on either the civil lawsuits or or other news reports about the allegations against Perdue And how hard will it be for prosecutors to prove any sort of criminal wrongdoing. Well, um, as I understand it. Uh. The basis for the for these criminal proceedings is that the drug company misrepresented the efficacy of the drug, saying it would last twelve hours,

when in fact it rarely did that. This is in part due to the fact that it's sort of front loaded, so you get most of the or a large part of the opioid analgesic effect early in the in that twelve hour period and it just sort of tapers off to practically nothing by the end, so that means people would start taking it taking a new dose sooner rather

than later. Uh and And it's alleged that Produced had its sales reps misrepresent this, uh two doctors uh and and so this is largely the the The interesting thing is it's sort of like groundhog Day. They were led guilty to essentially the same charges in two thousand and seven, and we're fined a substantial amount of money, and it looks like they're back at it again. And Leo produced said that that it's misconduct that it pleaded guilty to was only from through two thousand one, and then it

stopped and they regret what they did. Is there proof that, uh, that you've seen or that you know of that the FEDS have that it's still going on. I'm not you know, I would not want to comment on whether or not there's proof. I I don't know the case closely enough. UM.

I think that you know. Another aspect of this is, uh, basically the allegation that produm misrepresented the risk of misuse and addiction, which was for these long release UM formulations was supposed to be lower and it and it appears that perhaps it wasn't lower, and these drugs were made

out to be safer than than they were in fact. UM. But you know, certainly, UM, there may have been continued uh wrongdoing on the part of some representatives who continued to essentially make claims about the medication that we're not we're not rooted in the evidence. Richard, What is the fact that that there might be ongoing wrong doing? Tell us about that earlier plea agreement? I mean usually, I think plea agreements have provisions in them that try to

make sure that the defendant doesn't doesn't repeat the behavior. UH. Can we infer can we imagine that maybe that that agreement wasn't tough enough one perdue. Well, I'm not sure that. I'm sure there was a memor memorandum of agreement. That's uh. And I think the interesting aspect of this, and I don't know the answer, is how long it was supposed to last. It's not necessarily forever, So once the scrutiny was off, they may have reverted back to what they

were doing before. At least that seems to be what the government is alleging. Leo. There are all kinds of problems with the opioid crisis. There's addiction, there's treatment, there's regulatory policy, enforcement, all kinds of different things. Is there one area that you would cite as the most important

to handle immediately? And you have about forty seconds here? Sure, I think, uh, you know, first, stop people from dying when they order, so, making sure that people are revived and receive help, and that, you know, moving upstream, making sure that people have access to adequate and evidence space drug treatment. Those are the two top priorities to sort of bend the curve right now, Richard, Do you want

to mention your top priority in your mind? Well, I'm not sure what that would be, but I would say that the litigation, the civil litigation that you spoke of earlier, is probably not going to be uh much of a much of a solution. It might enrich state governments, but I don't know if it's going to do very much to alleviate the obioid crisis. Thank you both for being

on Bloomberg Law. That's Richard Ousiness, a professor at the University of Kentucky School of Law, and Leo Biletsky, professor at Northeastern University Law School, coming up on Bloomberg Law. A federal judge has rejected a request from eighteen states and d C to force the Trump administration to resume paying Obamacare subsidies, so called cost sharing reduction payments to health insurers. This is Bloomberg