The National Attorneys General Training & Research Institute

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

Substance Abuse Newsletter July 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

The U.S. Food and Drug Administration (FDA) approved the first generic versions of Suboxone (buprenorphine and naloxone) sublingual film (applied under the tongue) for the treatment of opioid dependence. “The FDA is taking new steps to advance the development of improved treatments for opioid use disorder, and to make sure these medicines are accessible to the patients who need them. That includes promoting the development of better drugs, and also facilitating market entry of generic versions of approved drugs to help ensure broader access,” said FDA Commissioner Scott Gottlieb, M.D.

An article recently published in the journal JAMA Neurology, titled The Emerging Role of Inhaled Heroin in the Opioid Epidemic, provides information regarding severe physical problems that may arise from ingesting heroin via inhalation of its fumes after heating, commonly referred to as “chasing the dragon.” The article may be accessed here.

Wendy Guzman, 39, and Orlando Veras-Ruiz, 36, of Lawrence, Massachusetts, were arraigned on fentanyl trafficking charges after authorities seized 800 grams of fentanyl in a joint state, local, and federal investigation by the Massachusetts State Police troopers assigned to the Massachusetts AG’s Office, the U.S. Drug Enforcement Administration, the Massachusetts State Police Commonwealth Interstate Narcotics Reduction Enforcement Team (CINRET), and the Worcester Police Department.

Attorney General Brad Schimel announced the Wisconsin Department of Justice (DOJ), in partnership with the Department of Veterans Affairs (VA) Great Lakes Health Care System, is now offering a Dose of Reality to military veterans and active service members on the dangers of misusing opioid and narcotic pain medications. This new phase of the campaign features customized brochures, flyers, posters, and social media graphics targeted at military veterans and active service members and their influencers – family members, friends, and fellow service members. “Here’s a dose of reality: U.S. veterans are two times more likely than non-veterans to suffer from a fatal overdose from opiates,” said Attorney General Schimel. “Partnering with the VA on this new phase of Dose of Reality will give military veterans and active service members, and their families, the tools and resources to prevent opioid abuse.”

The New York State Association of Coroners and Medical Examiners, in conjunction with the state Association of Counties, has launched a new public awareness campaign to educate New Yorkers about the grim consequences of opioid use. A 60-second educational video produced with financial support from the coroners and medical examiners and NYSAC shows a man wearing a coroner's office jacket arriving at what appears to be a home of a middle-class upstate resident for an apparent drug overdose of a resident. The video may be accessed here.

A new Kaiser Family Foundation analysis finds that while the use of prescription opioids among people with employer-based health coverage has declined to its lowest levels in over a decade, the cost of treating addiction and overdoses has increased sharply. The annual cost of treating opioid addiction and overdose – stemming from both prescription and illicit use — has increased by more than eight-fold since 2004, from $0.3 billion dollars to $2.6 billion in 2016. Among people with an inpatient episode, the average inpatient expenses for opioid addiction treatment totaled $16,104 per year in 2016, up from $5,809 in 2004. A majority (53%) of spending paid for the treatment of enrollees’ dependent children.

Attorney General Jeff Sessions announced Operation Synthetic Opioid Surge (S.O.S.), a new program that seeks to reduce the supply of deadly synthetic opioids in high impact areas and to identify wholesale distribution networks and international and domestic suppliers. As part of Operation S.O.S., the Department will launch an enforcement surge in ten districts with some of the highest drug overdose death rates. Each participating United States Attorney’s Office (USAO) will choose a specific county and prosecute every readily provable case involving the distribution of fentanyl, fentanyl analogues, and other synthetic opioids, regardless of drug quantity. The surge will involve a coordinated DEA Special Operations Division operation to insure that leads from street-level cases are used to identify larger scale distributors. In addition, the Organized Crime Drug Enforcement Task Forces (OCDETF) Executive Office will send an additional two-year term Assistant United States Attorney to each participating district to assist with drug-related prosecutions. The ten participating districts are: Eastern District of California; Eastern District of Kentucky; District of Maine; District of New Hampshire; Northern District of Ohio; Southern District of Ohio; Western District of Pennsylvania; Eastern District of Tennessee; Northern District of West Virginia, and the Southern District of West Virginia.

The National Center for State Courts has created a National Judicial Opioid Task Force to assist state courts in effectively managing the impact of the opioid crisis on court dockets across the country and to assist all branches and layers of government to find solutions to this epidemic.

Medical/Marijuana/Synthetics

Recreational marijuana is now legal in Vermont, the ninth state to legalize it. Adults over age 21 will be able to possess up to 1 ounce (28 grams) of marijuana, two mature marijuana plants, and four immature plants. Smoking marijuana is barred in public spaces, and renters need permission from their landlords to use or grow at home. Vermont was the first state to legalize recreational marijuana through a legislative vote. It decriminalized marijuana in 2013 and legalized medical marijuana in 2004.

New York Governor Andrew M. Cuomo announced further action to support the development of medical marijuana and industrial hemp businesses in New York, directing the Department of Financial Services (DFS) to provide guidance to support the safe and sound provision of banking services for these businesses. The DFS guidance information encourages New York State chartered banks and credit unions to consider establishing banking relationships with medical marijuana-related businesses that are operating in New York in full compliance with all applicable New York State laws and regulations, including the New York Compassionate Care Act, and the applicable regulations and requirements of the New York State Department of Health. The information also encourages New York State-chartered banks and credit unions to support the development of industrial hemp businesses statewide. The guidance memorandum may be accessed here.

The National Law Review has published an article titled “In the Weeds: Navigating the Shifting Federal Regulation of Medical Marijuana.” This article provides an overview of the roles of FDA and other federal agencies in regulating the research, development, and marketing of medical marijuana, along with a discussion on DEA’s rescheduling process for controlled substances and its past actions related to marijuana. It also provides information on proposed congressional legislation focused on relaxing medical marijuana regulations and considerations for stakeholders in light of this shifting regulatory landscape. The article may be accessed here.

Other

Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Alex M. Azar III, announced the largest ever health care fraud enforcement action involving 601 charged defendants across 58 federal districts, including 165 doctors, nurses, and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings. Of those charged, 162 defendants, including 76 doctors, were charged for their roles in prescribing and distributing opioids and other dangerous narcotics. Thirty state Medicaid Fraud Control Units also participated in today’s arrests. In addition, HHS announced that, from July 2017 to present, it has excluded 2,700 individuals from participation in Medicare, Medicaid, and all other Federal health care programs, which includes 587 providers excluded for conduct related to opioid diversion and abuse.

Attorney General Jeff Sessions announced the appointment of Uttam Dhillon as Acting Administrator of the Drug Enforcement Administration. Dhillon will replace Robert Patterson, who has retired after 30 years of service.


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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