The National Attorneys General Training & Research Institute

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

Substance Abuse Newsletter March 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. Drug Enforcement Administration has launched a new tool to assist drug manufacturers and distributors with their regulatory obligations under the Controlled Substances Act. DEA added a new feature to its ARCOS (Automation of Reports and Consolidated Orders System) Online Reporting System, a comprehensive drug reporting system that monitors the flow of controlled substances from their point of manufacture through commercial distribution channels to the point of sale at the dispensing/retail level. This newly added function will allow the more than 1,500 DEA-registered manufacturers and distributors to view the number of competitors who have sold a particular controlled substance to a prospective customer in the last six months. DEA regulations require distributors to both “know their customer” and to develop a system to identify and report suspicious orders.

Drug manufacturer Purdue Pharma LP has announced that it will no longer advertise its opioid painkiller medications to doctors. In early February, the pharmaceutical company informed its employees that half of its sales force would be laid off, reducing the number of sales representatives to 200 employees. On Monday, February 12, letters from Purdue Pharma began to arrive at medical offices, announcing to doctors that the company would no longer be marketing its most popular painkiller, OxyContin. Any future questions that doctors might have for the company will no longer be handled by the marketing team, as had been the policy at Purdue Pharma in the past. Instead, inquiries will be directed to the medical affairs team.

New Jersey Attorney General Gurbir Grewal announced a statewide initiative to combat the opioid crisis, including a 24-hour response team and an improved prescription monitoring program funded with more than a million dollars in federal grants. "The opioid crisis is unprecedented in its scope and devastating in its intensity, and our response must be equally broad in scope and intensity," General Grewal said. The efforts will be overseen by the newly formed Office of the New Jersey Coordinator for Addiction Response and Enforcement Strategies, known as "NJ CARES," which will exist within the state's Department of Law and Public Safety.

In just one year, overdoses from opioids jumped by about 30 percent, according to a report released by the Centers for Disease Control and Prevention. The overall increase in opioid overdoses seen in hospital emergency rooms between the third quarter of 2016 and the third quarter of 2017 occurred across the nation. Some parts of the country experienced far greater increases, while a few have reported declines, the analysis shows. The largest regional increase occurred in the Midwest, which saw a 69.7 percent jump in opioid overdoses, according to the report. The jump was driven in part by a 109 percent increase in Wisconsin. Overdoses increased 40.3 percent in the West, 21.3 percent in the Northeast, 20.2 percent in the Southwest, and 14 percent in the Southeast. The report may be accessed here.

A genome wide association study has identified a new genetic alteration in European Americans with opioid dependence. The study, published in Biological Psychiatry, included over 3,000 opioid exposed people. The new findings provide insight into the biological origins of opioid dependence. “It’s widely recognized that we need a better understanding of the biological influences on opioid use—it is possible that biological understanding can lead to treatments,” said senior author Joel Gelernter, M.D., of Yale University.

Dr. Alan Summers, 79, of Ambler, Pennsylvania, was sentenced to four years in prison for running what prosecutors have described as the source of “more false prescriptions than perhaps any other clinic in the history” of Eastern Pennsylvania. Summers, a psychiatrist by training who pleaded guilty last year to more than 17 federal counts including conspiracy, health care fraud, and drug distribution, insisted that he founded his clinic to help his patients overcome addiction. He told the sentencing judge, “I was more shocked than anyone to realize that I had become a criminal.” “I put patients in harm’s way and deluded myself into thinking that that wasn’t happening.” In a document that agents later seized from his computer titled “Ten Year Financial Plan,” Summers laid out his goal to leave his wife and stepdaughter $5 million by the time he retired and noted that at his current rate of savings, he would reach only one-tenth of that sum. “The conservative approach is a guaranteed loser,” he wrote. He detailed instead a plan he described as the “aggressive approach” based on getting hundreds more patients to come to his clinic through aggressive marketing and writing prescriptions as fast as possible.

Medical/Marijuana/Synthetics

Michigan’s Department of Licensing and Regulatory Affairs has released an official symbol to label medical marijuana products that are sold in the state and is detailing required labeling for such products. The symbol is an upside-down green triangle with an image of a green marijuana leaf in the middle along with the words "CONTAINS THC" above it.

A Denver coffee shop received city approval Monday for the nation’s first business license to allow marijuana use by patrons under a 2016 voter-approved initiative. The Coffee Joint soon can allow customers age 21 or older to vape or consume edibles they bring to the cafe, which is already open. The shop will not allow any smoking, which is allowed only outdoors under state law, and can’t sell any marijuana products on site. Onsite consumption will begin after building and safety inspections are concluded.

Methamphetamine

On February 20, 2018, Fortuna, California, Police Department detectives arrested a 79 year old Fortuna resident after receiving information that she was selling methamphetamine out of her residence. Detectives obtained a search warrant and arrested Barbara Engels after locating 3 grams of methamphetamine at her residence in the 2100 block of Smith Lane in Fortuna. Along with the methamphetamine, detectives also located scales and packaging materials, all which were seized as evidence.

Kratom

The Center for Disease Control has issued a warning to consumers to not consume kratom in any form because it could be contaminated with salmonella. Read the CDC advice to consumers here.

The U.S. Food and Drug Administration announced the voluntary destruction and recall of a large volume of kratom-containing dietary supplements manufactured and distributed nationwide under the brand names Botany Bay, Enhance Your Life, and Divinity by Divinity Products Distribution of Grain Valley, Missouri. In cooperation with the FDA, the company has agreed to stop selling all products containing kratom. Based on the scientific evidence of the serious risks associated with the use of kratom and in the interest of public health, the FDA encourages all companies currently involved in the sale of products containing kratom intended for human consumption to take similar steps to take their products off the market and submit any necessary evidence, as appropriate, to the FDA to evaluate them based on the applicable regulatory pathway.

Other

Pennsylvania Court of Common Pleas Judge Craig T. Trebilcock handed down the highest sentence ever for a case of drug delivery resulting in death in Pennsylvania: 27 to 54 years in prison . Judge Trebilcock explained why he imposed consecutive sentences: McKenzie Reese sold heroin laced with fentanyl that resulted in Arissa Clymer’s death. He brought up the factors that go into fashioning a sentence: punishment, rehabilitation, and deterrence, specific and general. “Those who are selling heroin and fentanyl are merchants of death,” Trebilcock said. “They need to be deterred by strong messaging from the court.” “Ms. Clymer has responsibility for what happened. The prescription company hasresponsibility. The medical community has responsibility. The justice system has responsibility,” he added. Reese, he noted, had a significant prior criminal record including three DUIs, possession of marijuana, terroristic threats, and burglary.

Wayne County, New York, has been chosen as a regional site for a 24/7 Open Access Center in the continuing battle against substance abuse. The county’s mental health department was recently awarded $450,000 by the state to expand access to substance abuse treatment in the county and surrounding counties of the Finger Lakes Economic Development Region. The funding was announced last week by Gov. Andrew Cuomo’s office. The state is awarding $4 million to open 10 new 24/7 centers. The primary goal of the center is to make sure anyone in need of substance abuse disorder services has immediate access to addiction treatment services 24 hours a day, 7 days a week. Staff will be on hand to help people, family members, and law enforcement with treatment services for those in need.

A new report examines state and regional trends in mental health, substance use, and care access, in the hope of leading the way to increased advocacy and intervention. Michele Hellebuyck, a program manager at Mental Health America, says the State of Mental Health in America 2018 report was compiled by calculating weighted scores of measures from the Substance Abuse and Mental Health Services Administration’s (SAMHSA's) National Survey on Drug Use and Health (NSDUH). Mental Health America's analysis includes measures of alcohol dependence, marijuana use, heroin use, and cocaine use over the past year in both adults and youths. The report notes that 18% of adults nationally have a mental health condition and about half of them have a concurrent substance use disorder. Half of adults with mental health disorders go without treatment for their mental health problem. States with higher rankings in the report had better outcomes in most measures, meaning these states had lower rates of mental illness and substance use and better access to care.


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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