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The National Attorneys General Training & Research Institute The National Attorneys General Training & Research Institute

Substance Abuse Newsletter May 2018

The following is a compendium of news reports over the past month that may be of interest to our AG offices who are dealing with substance abuse issues. Neither the National Association of Attorneys General nor the National Attorneys General Training & Research Institute expresses a view as to the accuracy of news accounts, nor as to the position expounded by the authors of the hyperlinked articles.

Opioids

On April 13, 2018, the United States intervened in five lawsuits accusing Insys Therapeutics Inc., of violating the False Claims Act in connection with the marketing of Subsys, an opioid painkiller manufactured and sold by Insys. Subsys is a sublingual spray form of fentanyl. In 2012, Subsys was approved by the Food and Drug Administration for the treatment of persistent breakthrough pain in adult cancer patients who are already receiving, and tolerant to, around-the-clock opioid therapy. As stated in the complaint, the United States alleges that Insys paid kickbacks to induce physicians and nurse practitioners to prescribe Subsys for their patients. Many of these kickbacks took the form of speaker program payments for speeches to physicians that were, in fact, shams; jobs for the prescribers’ relatives and friends; and lavish meals and entertainment. The United States also alleges that Insys improperly encouraged physicians to prescribe Subsys for patients who did not have cancer, and that Insys employees lied to insurers about patients’ diagnoses in order to obtain reimbursement for Subsys prescriptions that had been written for Medicare and TRICARE beneficiaries.

Maryland Attorney General Brian E. Frosh announced that the Honorable Michael Wachs of the Circuit Court for Anne Arundel County convicted Tormarco Harris, 32, of Baltimore, on all counts in a 21-count superseding indictment after a 3-day bench trial. Specifically, Judge Wachs convicted Harris of one count of violating Maryland’s drug kingpin statute; one count of conspiring to distribute controlled dangerous substances; 18 counts of distributing controlled dangerous substances; and one count of maintaining a common nuisance. Sentencing has been scheduled for June 12, 2018. At sentencing, Harris faces a 20-year mandatory minimum prison sentence under Maryland’s drug kingpin statute and up to 20 years’ imprisonment on each of the conspiracy and distribution charges. According to evidence admitted at trial, Harris and Dr. Kofi Shaw-Taylor owned and operated Starlife Wellness Center in Glen Burnie, Maryland. From June 2015 through August 2017, Harris and Dr. Shaw-Taylor ran Starlife as a pill mill, where, in exchange for cash, patients received unlawful prescriptions for large quantities of narcotics, including oxycodone, morphine, tramadol, and benzodiazepine.

More than $1.2 million worth of illegal drugs, including a large stash of fentanyl, was seized during a drug bust in Oswego County, New York. Jeremy A. Acosta was arrested by the Oswego County Drug Task Force and charged with possessing over 1,600 grams of drugs. Acosta was arrested after officers executed a search warrant at his City of Oswego apartment building. Officers recovered: 1,230 grams of fentanyl worth $1,000,000, 324.3 grams of heroin, worth $216,200, and 62.1 grams of crack cocaine worth $6,210. The total street value of the fentanyl, heroin and crack cocaine is about $1,222,410. Acosta has been charged with two counts of first-degree criminal possession of a controlled substance which is a felony punishable by up to 25 years to life and third-degree criminal possession of a controlled substance. The Oswego County Drug Task Force is made up of members of the Oswego County District Attorney's Office, the Oswego County Sheriff's Office, state University Police at Oswego, U.S. Border Patrol, and the Oswego City Police Department.

Doctors who treat patients for opioid addiction can now get free phone advice from experts at the University of Arkansas for Medical Sciences. The university began offering a phone service providing one-on-one help on topics such as prescribing treatment medication, billing issues, and connecting patients to other services. Michael Mancino, director of the Center for Addiction Services at UAMS, said he can also interview a patient over the phone to help with a diagnosis. In August 2018, UAMS will also begin weekly video conferences offering information on treating opioid addiction. Mancino said both services, supported by $600,000 in federal funding from the state drug director's office, are aimed at increasing the number of doctors in the state who provide medication-assisted treatment for opioid addiction.

In Louisiana, following passage of SB 26, legislation that grants nurses and hospice organizations the lawful ability to dispose of drugs upon the deaths of their patients, Attorney General Jeff Landry revealed a new partnership with Mallinckrodt that makes available for free 30,000 drug deactivation pouches to Louisiana hospice providers. “Almost half of all opioid misuse starts with a friend or family member’s prescription,” said General Landry. “So we are committed to doing all that we can to get these potent drugs out of the wrong hands . . . . I am grateful for this important work by the Legislature and this valuable public-private partnership,” he said.

Colorado launched a nearly $1.8 million public awareness campaign aimed at ending the stigma around opioid addiction, with the hopes of encouraging more people to seek treatment. The “Lift the Label” campaign will include print, television, and digital advertisements designed to educate the public about opioid dependency through stories of addiction and recovery in Colorado. Robert Werthwein, who leads the Department of Human Service’s Office of Behavioral Health, said the hope is that the effort will complement work to increase treatment options for those suffering through addiction. The campaign is funded by the State Targeted Response to the Opioid Crisis grant.

Medical/Marijuana/Synthetics

Michigan voters will decide in November whether to allow recreational marijuana after officials certified there were enough signatures to put the measure on the ballot. The proposal, which the bipartisan state elections board allowed to proceed on a 4-0 vote, would make Michigan the 10th state and the first in the Midwest to legalize the drug for recreational purposes. It would allow people 21 and older to possess up to 2.5 ounces (71 grams) of marijuana and grow up to 12 plants at home. A 10 percent tax on marijuana would be assessed on top of the 6 percent state sales tax. Michigan voters legalized marijuana for medical use in 2008.

A Cambridge, Massachusetts, medical marijuana dispensary is being sued in federal civil court by its neighbors. Harvard Square business owners say the facility is lowering property value by millions. Healthy Pharms is a medical marijuana facility, but this federal case could set precedent for the recreational marijuana industry. Crimson Galleria owner Raj Dhanda says ever since medical marijuana dispensary Healthy Pharms opened last December in Harvard Square, his property value has decreased by over $27 million and his tenants have been adversely impacted. In the first-of-its-kind case in Massachusetts, Dhanda and other property owners are suing the dispensary and nearly a dozen others in federal court under the RICO statute, which could triple the alleged damages to over $81 million.

The Arkansas Supreme Court will hear oral arguments over a judge’s decision to prevent the state from licensing companies to grow medical marijuana. Justices agreed to hear arguments on June 7, 2018, in the state’s appeal of Pulaski County Circuit Judge Wendell Griffen’s decision which struck down the licensing process for medical marijuana cultivation facilities. Griffen ruled the process violated the voter-approved constitutional amendment legalizing marijuana for certain medical conditions. Griffen ruled in favor of an unsuccessful applicant for a cultivation license that had challenged the commission’s decision to issue permits to five businesses.

In 2017, more than 5,000 people were arrested for smoking or possessing small amounts of marijuana. Many of those arrested were minorities. Manhattan District Attorney Cyrus Vance Jr. announced his office would decline to take up those cases, effective August 1, 2018. "The dual mission of the Manhattan DA's office is a safer New York and a more equal justice system," Vance said. "The ongoing arrest and criminal prosecution of predominantly black and brown New Yorkers for smoking marijuana serves neither of these goals." Vance said his office was discussing with New York City police and Mayor Bill de Blasio what exceptions there should be to the policy. New York Police Commissioner James O'Neill announced a working group will review enforcement measures by the department.

The Pennsylvania Department of Health approved temporary changes to the Commonwealth’s medical marijuana program that will add addiction to the list of qualifying conditions. This new measure would allow people in recovery to apply for the program, which allows marijuana use for a treatment of a serious medical condition, as defined by the state's Medical Marijuana Law. Pennsylvania Secretary of Health Dr. Rachel Levine said this form of treatment won’t be the first and only option for people in recovery, but it could be an option for some. “It’s important to note that medical marijuana is not a substitute for proven treatments for opioid use disorder,” Levine said. “In Pennsylvania, medical marijuana will be available to patients if all other treatment fails, or if a physician recommends that it be used in conjunction with traditional therapies.” These new regulations take effect May 17, 2018.

Methamphetamine

Centralia, Washington, police said 126 pounds of methamphetamine were found in a truck hauling Starbucks products between California and Spokane. The truck’s interior was searched, and police said they found 40 bundles of meth in a television box on the top bunk of the sleeper berth. Police said they found another 50 bundles of methamphetamine, 2.4 pounds of suspected heroin, several thousand Oxycodone pills and a few grams of cocaine under a mattress. The driver of the truck, identified by a Mexico driver’s license as 22-year-old Carlos Alejandro Luna-Rodriguez, and his passenger, 62-year-old Bernardo Olivas-Leyva from California, were booked into the Lewis County Jail, police said.


Other

Oklahoma Attorney General Mike Hunter has charged a nurse practitioner and her supervising physician with one count each of unlawful distribution of a controlled dangerous substance after an investigation by his office and the Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD). Dr. Azuka Egbuniwe, 48, is accused of signing prescriptions for schedule II substances for patients she never met with while working as a supervising physician for nurse practitioner Addie Gratz, 43, who owns the First Choice Wellness Center in Tishomingo. Although nurse practitioners in Oklahoma are not required to have physician supervision to practice, state law requires physicians to supervise nurse practitioners when prescribing certain kinds of medication, like schedule II drugs. Attorney General Hunter commended the joint effort between his office and the OBNDD.

Parents want to be sure their child care provider is not impaired by marijuana, alcohol, or tobacco, but “our research concludes that state laws may not in fact prevent this from happening,” Elyse R. Grossman of Johns Hopkins Bloomberg School of Public Health in Baltimore told Reuters. Grossman and her colleagues found that almost all states have banned tobacco use in child care settings but only 13 states restrict marijuana possession, 17 restrict tobacco possession, and 20 restrict alcohol possession. “Without these regulations, young children may accidentally find and consume these products,” the researchers write in the American Journal of Public Health. Overall, the researchers found, states regulate tobacco, alcohol, and marijuana more strictly in child care centers than in home-based child care.

Troopers with the Nebraska State Patrol have seized 117 pounds of narcotics during a traffic stop on Interstate 80 near Kearney. The traffic stop occurred at approximately 10:20 a.m. on Thursday, April 26, 2018, when a trooper observed an eastbound 2013 Freightliner truck-tractor and semi-trailer driving on the shoulder near mile marker 280. During the stop, the trooper became suspicious of criminal activity. Troopers searched the vehicle and discovered a false compartment located in the empty trailer. The compartment contained 42 foil-wrapped packages containing 73 pounds of cocaine and 44 pounds of an unknown powder suspected to be fentanyl. The two narcotics carry an estimated street value of $5 million-$10 million.


Joanne Thomka is the Editor of Substance Abuse News and may be reached at 202-326-6269. Substance Abuse News is a publication of the National Association of Attorneys General. Any use and/or copies of this newsletter in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in this publication. For content submissions or to contact the editor directly, please e-mail jthomka@naag.org.

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