For the first time in six years, the DEA has ordered a suspension on a pharmaceutical wholesaler, and it’s a Big Pharma opioid distributor- Morris & Dickson.
We now know that officials all over the country, both at the state and federal levels, are joining forces to go after Big Pharma companies for pushing powerful opioid painkillers that contributed to one of the greatest addiction outbreaks in American history. While not everyone agrees on the role prescription drugs played in the opioid crisis, many believe the questionable marketing and distribution practices is reason enough for real intervention.
Lawsuits against opioid makers are taking place all over the US, and distribution companies are finding themselves in the hot seat.
DEA vs Opioid Distributor
This latest news comes following an investigation into Morris & Dickson. Allegedly, the investigation uncovered evidence that the Big Pharma opioid distributor neglected to inform the DEA about large quantities of addiction painkillers being bought up by independent pharmacies.
This is a problem because, according to The Hill, reporting such information to the DEA is a requirement.
Back in October of 2017 the investigation into the opioid distributor out of Shreveport, Louisiana got kicked off after reports came in that Morris & Dickson had sold narcotics to five of the state’s top 10 drug-purchasing pharmacies, but never filed any suspicious activity reports in any of these cases. In a statement Friday, the Justice Department revealed that according to the DEA investigation, independent pharmacies were allowed to purchase six times the amount they would normally order from the opioid distributor.
For the record- pharmaceutical distributors like Morris & Dickson are legally required to report unusually large shipments of narcotics to the government as a safeguard against prescription medications from making their way to the illicit drug market. DEA Acting Administrator Robert W. Patterson said in a statement:
“Distributors have an obligation to ensure that all pharmaceutical controlled substances their customer’s order are for legitimate use, and it is their duty to identify, recognize and report suspicious orders to DEA,”
“This is another reminder that DEA will hold accountable those companies who choose to operate outside the law.”
The Big Pharma opioid distributor will have the chance to appeal the suspension during an administrative hearing.
Morrison & Dickson Fight Back
Let the record show that Morrison & Dickson are definitely not taking these charges sitting down. The opioid distributor has struck back against the suspension with a federal lawsuit. They adamantly hold that they will fight the suspension. Company president Paul M. Dickson released his own statement, saying:
“Sadly, in this case, the DEA has gotten it wrong. We would’ve proved that to them had they given us the chance.”
They already asked a judge last Thursday to overturn the DEA suspension. In the legal claim against the DEA order the opioid distributor states:
“Make no mistake—this is a life and death situation. Morris & Dickson services 30-40% of the hospital drug market in Louisiana and Texas alone. If Morris & Dickson cannot ship needed medications to these hospitals, these hospitals may face immediate drug shortages.”
The company president also maintains that the opioid distributor has already greatly reduced its circulation of opioids. Dickson emphasizes that the company provides medications that many patients do desparately need. He also acknowledges the devastation caused by the opioid crisis, saying:
“Everyone in the Morris & Dickson family has been touched by the opioid crisis. That’s why we’ve taken aggressive and effective voluntary measures against any potential opioid diversion from medical use. We have reduced our opioid distribution dramatically. And it’s why we’re so proud of our history of 177 years with no outside enforcement actions against us.”
At this point, only time will tell if the company will have to adhere to the suspension for much longer.
Some people argue that moves like this from the DEA are too aggressive or an over-reach. However, given the circumstances, this seems like a logical response. Looking at the massive shipments of Oxycodone and Hydrocodone, it seems like it shouldn’t be too much to ask they notify the DEA.
What is Next?
Big Pharma executives testified for Congress yesterday, answering questions about their role in the prescription drug problem. The Washington Post reports that this could be a defining moment for the opioid industry. Witnesses for the hearing included high ranking executives from:
- Miami-Luken, INC
- McKesson Corporation
- Cardinal Health
- AmerisourceBergen Corporation
- HD Smith Wholesale Drug Company
During the hearing, Congressman Gregg Harper of Mississippi states:
“We have learned much from the investigation but still have many questions,”
“Why did the distributors repeatedly fail to report suspicious orders of opioids or exercise effective controls against diversion?”
He goes on to explain that the DEA identified opioid distributor companies as a key element to combating the diversion of drugs to the black market. He states that distributors have often claimed that they were too limited to properly address these issues, as they do not understand the whole scope as the DEA does. However, he argues that distributors do have a great deal of data collection, and should be aware of their impact.
According to Congressman Harper, distributors also frequently argue that they are simply providing a service. They do not control the demand, but simply offer the supply based on the prescriptions from physicians. This argument seems a bit of a cop-out, and almost sounds like something a street-level drug dealer would say.
The committee also adds that over the course of 6 years, opioid distributor companies filled the state of West Virginia with over 780 million Hydrocodone and Oxycodone pills, while 1,728 people in West Virginia fatally overdosed on those two painkillers.
In their opening statements, each Big Pharma distributor representative acknowledged the devastation of the epidemic. However, when asked by Chairman Harper if they believed their companies contributed to the opioid epidemic, except for the chairman of the board for Miami-Luken Dr. Robert E. Mastandrea, they all said no.
In fact, Dr. Mastandrea seemed to be the only one consistently willing to admit that Miami-Luken had made mistakes that helped create the opioid crisis.
While it will take time to determine the impact of these testimonies, one thing we can say now is that drug distribution companies are quickly finding themselves on the chopping block when it comes down to the efforts to curb prescription opioids abuse.
For now, a crucial part of fighting the opioid epidemic is going to be providing safe and effective addiction treatment. It may not be easy to put a stop to the spread of addiction, but there are programs that can help you break out of the cycle of drug and alcohol abuse. If you or someone you love is struggling, please call toll-free now. We want to help.
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8 months ago, Florida was home to 953 licensed drug treatment centers, and 207 were in Palm Beach County. As of April 1, there are now 185 in Palm Beach, with 771 in the whole state. This decrease is due to the crackdown on fraud by Palm Beach State Attorney’s Office, which has led to 45 arrests in the last year and a half. So far, those arrests have led to 16 convictions. For State Attorney Dave Aronberg there is no sign of slowing down.
Recently, Dave Aronberg spoke with Opioid Watch to talk about the work his office has been doing to try and strengthen the addiction treatment industry. Chief Assistant State Attorney Alan Johnson also sat down to talk about how Palm Beach County is fighting to protect those who are coming to Florida for help. Johnson heads the office’s Sober Homes Task Force.
Dave Aronberg VS Purdue Pharma
According to Aronberg, he got involved with opioid-related issues back in 2001, when he was an assistant attorney general. Aronberg says he was asked by his boss, Bob Butterworth, to investigate Purdue Pharma. This Big Pharma giant is the producer of OxyContin. This powerful prescription opioid has been credited with making a heavy contribution to the opioid crisis. Dave Aronberg was to examine the marketing practices of Purdue Pharma, and is quoted in the interview transcript stating:
“I believe we were one of the first in the country.”
Of course, now Purdue Pharma is one of many big name pharmaceutical companies being accused in lawsuits across America. In fact, Delray Beach, Florida recently filed its own case against the company.
When asked about what he found, Aronberg said that Purdue was marketing the product like it was Advil. Purdue has been repeatedly accused of pushing this product as if it was far less dangerous than it actually was. In 2002, Dave Aronberg was elected to state senate, and shortly afterward the case against Purdue was settled. In the edited interview transcript, Aronberg is quoted:
“Purdue also offered $2 million to the state to establish its first prescription drug monitoring program. I worked in the state senate to get the PDMP enacted into law. But some conservatives refused to go along. They thought it was Big Government. So Purdue’s $2 million went away, because the offer expired. We didn’t get the PDMP till 2011. By then the carnage was horrific.”
Furthermore, Opioid Watch notes that a Purdue spokesperson confirmed that the state failed to implement a PDMP by July 1, 2004, which was the expiration of the companies offer.
Dave Aronberg Goes to Congress
In December of 2017, Aronberg went in front of Congress to testify concerning fraud and abuse in the addiction treatment industry. In this meeting, they discussed various issues with shady facility operators in Florida and made suggestions on how the law could step in to change it and protect patients. The interview transcript quotes Aronberg:
“In recent years, we’ve had an influx of unscrupulous operators who enrich themselves by exploiting those in recovery. As a consequence, we’re attracting thousands of young people from throughout the country into fraudulent rehab centers. (We’re talking about some, not all. There are good rehab centers, too.)”
Again, Aronberg found himself at battle with shady marketing practices. While investigating the treatment industry, Aronberg’s office discovered illegal operations that not only manipulated insurance providers but put patients at extreme risk.
From patient brokering, where illicit actors would sell patients with insurance to the highest bidders, to illegal kickback schemes being run by sober homes to outpatient treatment programs. Chief Assistant State Attorney Alan Johnson added information about the exploitation of urine analysis costs, and even some programs that began billing insurers for allergy and DNA testing. Aronberg states:
“We have a doctor who billed $7 million in nine months for allergy tests.”
Needless to say, the task force and state officials had their work cut out for them.
The ACA, ADA, and FHA
When talking about the many scams being run by various illegitimate businesses, the conversation came back to insurance and how these cons run. Here Dave Aronberg talks about his beliefs on how the law should step in and help restructure the current system.
“Number one: Change the Affordable Care Act’s fee reimbursement model to an outcome-based reimbursement model. Where the good providers are rewarded and the bad ones are paid less. Right now, the opposite occurs, so the more times you fail, the more money you get. There’s an incentive for more services and for more relapse. That shouldn’t be.”
After talking about the issues with the ACA, he talked about the ADA and FHA.
“The second change we need is this: the Americans with Disabilities Act and Federal Housing Act have been misused and exploited by bad actors who own flophouses.”
He went on to say,
“Local governments are largely prohibited from overseeing the sober home industry. If they want to require mandatory inspections, certifications, and registrations, they’re likely prohibited under federal law.”
In essence, Aronberg believes the law should allow local governments to create their own guidelines for health, safety and the general welfare of the patients. None of these demands seems outlandish, and with reasonable regulation, the reputable and effective providers in this industry can continue to best serve the South Florida recovery community.
Aronberg also points out that the problem is not only in Florida. Recently, he went to Orange County, California to meet with officials dealing with the same situation. Next for Dave Aronberg is leading the national task force of 34 prosecutors in 30 states. Their goal is to produce a working paper for setting best practices for prosecutors all over America concerning these issues. The task force also intends to make suggestions for changes to federal and state laws.
What might be most surprising though is the mention of harm reduction strategies?
“It’s about prevention, drug treatment, and innovative strategies. I think it will be powerful because it’s going to be prosecutors talking about needle exchanges and disposal and safe injection sites. People assume prosecutors are going to be focusing only on mandatory minimums and longer sentences. That’s not what this is about. I think it’s going to surprise people.”
While needle exchanges and safe injection sites have been proposed in numerous states, it is not the most popular idea. San Francisco is actually on track to open the first safe injection site in America, with Philadelphia not far behind, and Seattle and Baltimore in the conversation as well.
With Aronberg and the task force working to make a difference, hopefully, we will see the right change soon. We hope it will make the recovery community stronger as a whole. Reputable and respected providers are also doing their part to refine their practices while implementing innovative and effective resources to ensure that those who with drug or alcohol addiction always have a safe place in Palm Beach County to get the help they need. With the opioid crisis ongoing, having real resources for opioid treatment is still an essential part of overcoming the problem.
Palm Healthcare Company is a leader in holistic addiction treatment with over 20 years of helping people from all over the country heal mind, body and spirit. Providing safe and comprehensive care should always be a focus in the effort to overcome the drug problem, and preservation of life should always be a priority. If you or someone you love is struggling, please call toll-free now.
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The fight against prescription opioid abuse, heroin, and fentanyl in America continues to intensify. Our political landscape may soon see even more drastic shifts because of it. Controversy and conjecture have surrounded many ideas brought to the table on both sides. Even the President himself has been behind some pretty divisive propositions. Then Monday, President Trump unveiled his plan for combatting the ongoing opioid crisis in America while in New Hampshire.
During his speech, the President talked up a few key elements of his plan; some we have heard of before, and others have only recently become a serious topic of conversation. As the administration puts the final touches on their proposals, we thought should take a look at some of the highlights and see which of his plans could actually work, and why experts and advocates believe others probably won’t.
Arguably, there are some pretty good ideas here… and some pretty bad ones, depending on who you ask.
An Opioid Vaccine
Let’s kick this off on a high note.
The Trump opioid plan includes supporting the search for a vaccine. This honestly seems like a good ambition to get behind, but will it work? Researchers at the Walter Reed Army Institute of Research and the National Institute on Drug Abuse developed an experimental heroin vaccine back in December. So far the compound has been tested with rats and mice. Their latest breakthrough found that antibodies in the vaccine bound to the heroin before crossing the blood-brain barrier. This reaction effectively prevents the euphoric effects of the drug.
While this is an exciting development, it is still a vast leap to go from treating mice to treating humans. We still have a long road ahead before this possible vaccine could be approved. However, more funding and resources from the federal government could make a big difference.
Even so, it is important to note that this vaccine will not be a cure-all answer that fixes everything. After all, we have seen opioid blocking methods before. Drugs like Vivitrol and other implants were also developed to hamper the effects of opioids, and they still haven’t stopped the crisis from growing. Experts are already saying this vaccine will only work in the short term and require repeated doses. It is expected to be an incredibly expensive treatment, and it may only be another variation of the Vivitrol shot. Still, some believe this vaccine, used alongside other treatment methods, could be a crucial tool in fighting opioids.
Big Pharma and Prescription Drugs
The Trump opioid plan also takes a look at prescription opioids. The President acknowledged the contribution of pharmaceutical companies and prescription drugs to the opioid crisis. In his statement, he indicated that this administration support research for opioid alternatives.
“That includes federal funding for the development of non-addictive painkillers.”
In talking about prescription drugs, President Trump said the administration also planned on addressing the issue of overprescribing addictive medications. He even touted the Justice Department’s new task force that may soon be fighting Big Pharma companies in court.
“Our Department of Justice is looking very seriously into bringing major litigation against some of these drug companies. We will bring it at a federal level.”
He acknowledges the recent work at the state level to hold Big Pharma accountable. President Trump said his administration will be working to reduce opioid prescriptions by 1/3 over the next three years. Hopefully, as time goes on there will not only be more accountability to those manufacturing these potent medications, but also more options for the thousands of people suffering from chronic pain who do need pain management.
This show we have seen (fail) before. The crisis probably isn’t going to get fixed with re-runs and reboots.
For a long time, Trump has been talking about creating a media campaign to try and combat the opioid crisis. In his remarks on Monday, the president said,
“We are thinking about doing a really large-scale rollout of commercials that show how bad it is for the kids… Scare them from ending up like the people in the commercials.”
Trump said he would spend a lot of money and direct people to make the commercials depict “pretty unsavory situations” claiming that this strategy has worked before with cigarette smoking.
Sadly, the reality is that we have tried this before. Using anti-drug messaging that specifically targets kids and young adults is exactly what was done with the “Just Say No” ad campaign of the 1980s and early 1990s, and the DARE program of the same period. Neither program was proven to be particularly effective in reducing drug use. Some have even argued it did the opposite and actually intrigued young people into drug use.
This is just one part of the Trump opioid plan that reminds people of the ideas pushed in the failed War on Drugs that already destroyed countless lives and only ended up making the problem worse.
So how will this new campaign be different?
The President also mentioned the importance of combatting the flow of illicit drugs like fentanyl and heroin into the country. He became particularly energized of course when talking about his proposed border wall with Mexico, saying,
“90% of the heroin in America comes from the southern border, where eventually the Democrats will agree with us and we will build a wall to keep the damn drugs out.”
However, many are not so convinced that the wall will be especially effective in stopping drug traffickers. Support for the wall experiences ups and downs as negotiations over immigration continue. Then the President took the opportunity to scrutinize sanctuary cities, calling out California and claiming these places were harboring the most terrible kinds of criminals, including drug dealers.
If part of the Trump opioid plan is to apply even more pressure to sanctuary cities, we may see more back-and-forth when it comes to compromises on immigration policy reform. Recently the Republicans were using DACA as a bargaining chip with Democrats to get the infamous border wall built, but now Trump says Democrats are holding onto it so they can use the issue during the election cycle.
Death Penalty for Drug Dealers
Now, THIS proposal is the one part of the Trump opioid plan that is causing the most controversy, and understandably so.
UPDATE: Attorney General Jeff Sessions sent out a memo Wednesday officially asking federal prosecutors to pursue the death penalty in drug trafficking cases “dealing in extremely large quantities of drugs”. So the administration is now implementing President Donald Trump’s plan to ramp up “tough on crime” punishments in response to the opioid crisis.
In his speech, the President brought having the death penalty for drug traffickers to the forefront. This is an extreme even some of his supporters believed was more tongue-in-cheek than actual proposed policy. The details on this proposal were still pretty scarce at the time. Some support Trump pushing for the death penalty, saying this punishment would only apply to high volume, kingpin-level dealers. But what we should consider is this:
- The federal death penalty is available for a few drug offenses. This includes violations of the “drug kingpin” provisions in federal law.
- Reports indicate that Trump wants Congress to pass legislation that will reduce the amount of drugs needed to trigger mandatory minimum sentences for traffickers.
So should we assume that the President intends to expand what qualifies as “drug kingpin” activity to make the death penalty easier to enforce? If so, what does that mean exactly? And what does it mean for further enforcing other mandatory minimums?
The Justice Department has said it would seek the death penalty “when appropriate under current law.” While drug-related murder is already a capital offense, no one has ever been executed by those rules. However, President Trump says that he and the Justice Department are working very hard to change the laws. To do so would require an act of Congress, and many believe Congress is highly unlikely to expand the federal death penalty. So will any of this be changing soon?
In his comments, President Trump stated,
“If we don’t get tough on the drug dealers, we are wasting our time. And that toughness includes the death penalty.”
President Trump’s call for the death penalty is being strongly met with condemnation. The proposal’s critics range from treatment advocates to law enforcement officials and civil liberty organizations.
Maria McFarland Sánchez-Moreno, executive director of Drug Policy Alliance, said in a statement,
“If this administration wants to save lives, it needs to drop its obsession with killing and locking people up, and instead focus resources on what works: harm reduction strategies and access to evidence-based treatment and prevention.”
Jesselyn McCurdy, deputy director of the American Civil Liberties Union’s Washington office, said,
“Drug trafficking is not an offense for which someone can receive the death penalty,”
McCurdy is referring to a Supreme Court precedent that puts constraints on using the death penalty for a convicted person who did not commit murder.
Furthermore, there are plenty of arguments that this kind of policy is not practical. Some say it would either be so broad it became unconstitutional, or so specific that it would be obsolete. This aspect of the plan has sparked nationwide debate. Americans everywhere are arguing whether or not a drug dealer should be responsible for the deaths of customers.
Sadly, this is so frustrating because past data does not hold with the idea that getting ‘tough’ on drugs is more effective than offering treatment opportunities. One of the best studies backing this is a 2014 study from Peter Reuter at the University of Maryland and Harold Pollack at the University of Chicago. Researchers determined that while simply prohibiting drugs to some extent does raise their prices, there’s no good evidence that tougher punishments or harsher supply elimination efforts do a better job of driving down access to drugs and substance misuse than lighter penalties.
In fact, many addiction advocates argue that harsher punishments can actually be counter-productive because they end up punishing people who need treatment, not incarceration. So the need for a more comprehensive approach to opioid addiction treatment is paramount. Hopefully, this administration will see the need to focus on support for treatment, instead of a primarily punitive focus.
Trump Opioid Plan on Treatment
This is a critical and commendable element of the Trump opioid plan, and I applaud some of its intentions. However, I wish we could talk a lot more about this and a lot less about captial punishment.
Still, I give them credit for saying they want to increase access to addiction treatment and adopting harm reduction. There isn’t much detail to go on though, as far as how this will happen. One aspect is to increase the use of medications such as methadone and buprenorphine.
As another highlight, Trump also asks Congress to repeal a rule blocking Medicaid payments to larger treatment facilities, which could provide a boost in the billions to inpatient clinics. Hopefully, this is one factor of the Trump opioid plan that will pan out, because one of the biggest issues the US faces with the opioid crisis is a limited access to adequate treatment options. If the White House allows Medicaid to reimburse larger treatment facilities, more people will be able to get effective care. Still, it is unclear how many resources the administration is willing to commit to treatment resources.
Hopefully, the Trump opioid plan will evolve and we will see a resurgence of resources going toward helping get people suffer the help they need. It is understandable to want to curb the rise of addiction through anti-trafficking measures and raising awareness, but we already have thousands and thousands of people struggling every day all over America who need help. Preventive steps are crucial, and the President is trying to push for them. But it is vital that we also give everyone already struggling more of a fighting chance. The possibility of more people having greater access could help create a huge shift.
Palm Healthcare Company believes in providing innovative and effective holistic treatment options for those who are battling with addiction. Our facilities believe in comprehensive and compassionate care, and our mission every day is to transform as many lives as possible. Together, we can make a difference. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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Attorney General Jeff Sessions made an announcement at a news conference Tuesday that the Justice Department will be creating a new task force to pursue the makers and distributors of prescription opioids. It seems that beyond pursuing new restrictions being put on prescriptions, there will be a more intentional focus on Big Pharma and those who many believe have made the opioid crisis possible.
Jeff Sessions said the task force will “examine existing state and local government lawsuits against opioid manufacturers to determine if we can be of assistance.”
Meanwhile, Sessions also included the Justice Department is going to be backing a lawsuit in Ohio against major prescription opioid makers.
Ohio VS Opioid Makers Lawsuit
In truth, this lawsuit isn’t just about the state of Ohio. It consolidates more than 400 complaints by cities, counties and Native American tribes nationwide. Buckeye Nation has definitely been hit hard by the opioid crisis, but for now, the stage is set here for a massive effort against questionable practices from opioid makers.
The lawsuit that solicits the Justice Departments attention is pending in Federal District Court in Cleveland. It goes after various companies for using misleading marketing to promote prescription opioids, including:
The lawsuit also accuses the defendants of:
- Downplaying the risk of addiction to these drugs
- Failing to report suspicious orders by consumers, which would indicate the drugs were being abused
Furthermore, there are some big names in Big Pharma being listed as defendants, including:
- Johnson & Johnson
- Purdue Pharma
- Teva Pharmaceuticals
The suit is also going after large distributors, such as:
Not to mention pharmacy chains like:
So how will the Justice Department be engaging in the current lawsuit? How will this new development impact the outcome of the case?
For more important information on the dangers of prescription drugs, download our
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Statement of Interest Against Opioid Makers
During the press briefing, Sessions explained that the Justice Department plans to file what is called a “statement of interest” in the Ohio lawsuit. This is a technique that past administrations typically would only resort to in cases that directly affect the federal government’s interests, such as diplomacy and national security.
However, with the intensity of the opioid crisis being what it is, it is perfectly understandable to make it such a high priority for the current administration to get involved with. So far, recovery advocates have been largely unimpressed with the half-measures that have been presented thus far with the Trump administration to address the issue.
By invoking the statement of interest, the attorney general is legally able to argue on behalf of the government’s interest in any court in the country. However, it does not make the government a plaintiff. All things considered, Sessions said his department will use criminal and civil penalties. He states,
“We will use whatever tools we have to hold people accountable for breaking our laws.”
Which is quite a statement, considering it isn’t at all common for criminal charges to be brought against Big Pharma.
The Devil Is in the Data
What brought the Justice Department into this began with a discussion on access to certain data. This past Monday, lawyers for the Drug Enforcement Administration (DEA) came to the Ohio courtroom to discuss how much data they would share about the national distribution of painkillers.
The DEA said it would only provide two years of information in the case, asserting that the agency did not want to compromise ongoing criminal investigations. However, Judge Dan Aaron Polster’s request is to provide the sides with nine years of data. He said the agency has until next Monday to decide whether it will comply. This data can assist in determining:
- The number of pills distributed
- The locations
- The distributors
This information could be crucial in allocating liability.
Richard Fields, a lawyer who represents state attorneys general and sovereign Native American nations in opioid litigation, predicts that the statement of interest from the Justice Department “will help unlock this data so that we can hold manufacturers, distributors and pharmacies accountable for flooding communities with pills.”
Therefore, it appears Sessions is going to be taking some big steps toward calling out Big Pharma for their involvement in the opioid crisis. Sessions says the government will be taking a hard look at doctors who overprescribe prescription painkillers. Even legal drugs like these too often lead to addiction and abuse of illegal drugs like heroin.
Ohio Attorney General Mike DeWine says he believes this is a game changer. With all the suffering communities in Ohio have seen over the past several years, we can only hope.
Holding Big Pharma accountable is a huge step. Nevertheless, we should also highlight the need for state and community officials to promote safe and effective addiction treatment. Innovative and holistic recovery programs can make a dramatic difference in helping heal communities. If you or someone you love is struggling, please call toll-free now.
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This past week the Center for Disease Control and Prevention (CDC) issued a statement warning people to stay away from Kratom while health officials investigate the possible connection between the plant and a nationwide outbreak of salmonella.
Multi-State Salmonella Outbreak
So far 11 people have been hospitalized as a result of this recent salmonella outbreak, and the CDC believes that kratom may actually be responsible for the recent chain of illnesses.
Since October, 28 cases of salmonella were recorded in 20 states, including:
- New York
- North Dakota
- North Carolina
- South Carolina
So far there have been no deaths, but nearly a dozen people have ended up needing to be hospitalized.
Most people infected with salmonella develop symptoms with 12 to 72 hours of exposure to the bacteria. Some symptoms include:
- Abdominal cramps
According to the advisory released by the CDC, 11 people affected by the salmonella outbreak were interviewed. Out of those 11 people, 8 of them admit to consuming kratom. That is a 73% connection so far. These individuals had taken the plant via:
Therefore, at this time kratom is the primary suspect in the CDC’s investigation. The advisory states:
“Epidemiologic evidence indicates that kratom is a likely source of this multistate outbreak. At this time, CDC recommends that people not consume kratom in any form because it could be contaminated with salmonella.”
But it wasn’t just the CDC. The very next day the Food and Drug Administration (FDA) issued a statement announcing the recall of “kratom-containing dietary supplements” manufactured and distributed by Divinity Products Distribution of Grain Valley, Missouri. This manufacturer is not yet determined to be the cause of the outbreak, but the company voluntarily recalled its kratom products and promised to stop selling them.
CDC, FDA, and DEA vs Kratom
At this time the FDA is encouraging other kratom companies to follow the Missouri company’s lead. They urge other manufacturers to- “take swift action to remove these products from circulation to protect the public.” The FDA Commissioner Scott Gottlieb states,
“To protect the public health, we’ll continue to affirm the risks associated with kratom, warn consumers against its use and take aggressive enforcement action against kratom-containing products.”
Proponents of kratom do argue that the FDA has been working especially hard in the last few years to prove that kratom is a threat to public health. In early February the FDA claimed it found evidence that certain compounds in kratom interact with the body’s opioid receptors. This led the agency to conclude that “compounds in kratom make it so it isn’t just a plant—it’s an opioid.” In America, the use of this plant is actually already banned in 6 states. The DEA also considers it a drug of concern. Even though back in October of 2016 the DEA announced they would not be banning kratom and giving it a schedule 1 label.
However, the American Kratom Association and other kratom advocates are willing to keep pushing back against the FDA. Many kratom users claim it is useful for helping addicts self-medicate to lessen the withdrawals when getting off heroin and other opioids. Yet, there is not enough research out there yet to fully endorse this claim, and a lot more would have to be done to legitimize it.
Either way, because kratom products are very loosely regulated by the FDA, it isn’t hard to understand why they are asking people to stop using the plant until they have been able to identify the source of the bacteria.
So far, no specific brands or suppliers have been singled out, but health officials are still urging people to be safe and avoid kratom products.
Many may still debate the benefits and the risks with kratom. Either way, both sides agree that more research is needed. Whether or not the drug should be banned is still a question that has yet to be answered. The one thing we do know is that kratom is a mind-altering substance, so using it might be detrimental to some people trying to recover from addiction. Right now, it doesn’t seem safe for anyone, anyway. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now. We want to help.
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Over the last 15 years, the suicide rate has climbed by an estimated 32%. While the overdose deaths in relation to the opioid crisis have become a constant issue around the country, some researchers suggest that the real suicide rates are even higher, but some of them are being misclassified as overdoses.
So, are more people dying due to drug abuse, or are more people taking their own lives using powerful street drugs and prescription narcotics?
Studying Suicide and Drugs
The idea that many of the deaths recorded as opioid overdoses may have been suicides, according to the researchers, is due to a significant gap between suicide rates and intoxication mortality rates.
A study from the Luskin School of Public Affairs at the University of California, Los Angeles, was published in the journal PLOS One. This study states that both suicide and drug intoxication death rates in the United States have risen over a period of 15 years. Researchers compiled data from the Center for Disease Control and Prevention (CDC) to show:
- 2000- The suicide rate was 10.40 per 100,000 people
- 2015- Suicide rate rose to 13.75 deaths per 100,000 people
- 2000- Drug intoxication mortality rate for those over the age of 15 was 7.81 deaths per 100,000
- 2015- Drug intoxication death rate for those over the age of 15 rose to 20.07 per 100,000 in 2015
This means that the drug intoxication death rate rose by 257% in those 15 years, while suicide rates only rose by 32%. While 32% is still a devastating number when it comes to such a tragic circumstance, there is still a huge difference between 32% and 257%. These researchers believe this major difference in the reports of mortality rates suggests a lack of suicide reporting.
Difficulties in Death Investigation
One of the big problems, according to the study’s author Mark Kaplan, is resources. Kaplan is a professor of social welfare at UCLA, and he stated to local news sources,
“Unfortunately, part of the problem is due to serious under-resourcing of state and local death investigation systems throughout most of the U.S.
“Many of these deaths were probably suicides, yet reported as accidental self-poisoning rather than intentional self-harm, particularly among the middle-aged.”
The study by Kaplan and his colleagues further explains that when it comes to suicide by overdose, things like an individual’s psychiatric history or the presence of a suicide note are crucial to helping professionals identify a death as a suicide.
“A suicide note, prior suicide attempt or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths,”
“Our incorporation of undetermined deaths, as well as registered suicides, not only provided a window on the nature of suicide misclassification within the undetermined death category but within the accident category—as a much larger reservoir for obscuring drug intoxication suicides.”
So by acknowledging that there is not always an obvious indication that a death is a suicide, even in cases that are classified in suicide, the researchers believe that many deaths that involved drugs have most likely been categorized as overdoses instead of making a deeper inquiry into the circumstances surrounding an individual’s death.
Opioids Causing Ambiguity
With the opioid crisis in America, it has become even more difficult to measure the suicide rates. And that isn’t just this research teams opinion either.
In 2015, the CDC hosted a meeting to address the challenges presented for medical examiners and coroners across the country. The primary focus was concerning cases of fatal intoxication due to opioids and other drugs. The summary of this meeting concluded that drug intoxication deaths may be among the most difficult to determine regarding the manner of death. The summary notes that reasons for such difficulty in having a more accurate manner of death include:
- Potentially equivocal evidence
- Intent to die
- Overlapping demographic groups affected
- Overlapping premorbid risk factors (e.g., substance abuse, mental health problems).
Opioid addiction, much like any other form of substance use disorder, is often closely connected to other issues, including anxiety, trauma and mental health disorders. Some individuals living with mental health conditions who abuse opioids may be self-medicating and accidentally overdose. But others may be suffering so severely, with conditions like depressive disorders or bipolar disorder, that they ultimately take their own lives intentionally with the powerful drugs. With opioid abuse being so widespread and devastating, the line between the two has begun to blur.
Both studies mentioned clearly indicate in order to truly comprehend an accurate number of suicides by overdose, more research is needed. Both also admit that the number may never be exact.
Even though we will probably never have a definitive answer, the question is still important to ask. By knowing whether opioid deaths are caused by accidents or intentional we can develop better strategies to provide education and prevention.
This is also why mental health should always be a priority when it comes to addiction treatment.
Substance use disorder and suicide are both connected to mental health and personal wellness. Too often they both lead to avoidable tragedies. Therefore, mental health and wellness should be a priority for addiction treatment. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
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