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

Substance Abuse Newsletter September 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 Center for Medicare and Medicaid Innovation is announcing a new model as part of a multi-pronged strategy to combat the nation’s opioid crisis. The Integrated Care for Kids (InCK) Model is a child-centered state payment model intended to improve the quality of care for children impacted by opioids who are eligible for Medicaid and the State Children’s Health Insurance Program. You can find more information on this important new model here.

Killing Pain, a seven part documentary series chronicling Oklahoma’s opioid addiction epidemic is available to view, free of charge. The in-depth documentary explores the public health crisis in Oklahoma from its origin to steps the state is currently taking to stem the epidemic. The series is presented by Fighting Addiction Through Education (FATE) and produced by Lampstand Media. The series also features personal stories of addiction, the economic cost of the crisis and the biology of addiction. Attorney General Mike Hunter appears in multiple episodes to discuss the state’s response and the lawsuit filed by his office last July. The series may be accessed here.

The Justice Department filed a complaint to bar two Ohio doctors from prescribing medications after an investigation revealed the doctors recklessly and unnecessarily distributed painkillers and other drugs. Temporary restraining orders—a first-of-its-kind against doctors allegedly prescribing opioids illegally under the Controlled Substances Act (CSA)—were served that forbid Michael P. Tricaso, D.O., of Akron, and Gregory J. Gerber, M.D., of Sandusky, from writing prescriptions. “At the Ohio Attorney General’s Office, we are committed to protecting Ohio families and collaborating with our law enforcement partners to ensure that those who ignore the law, put people at risk, and contribute to this crisis are held accountable for their actions” said Ohio Attorney General Mike DeWine. According to documents filed in U.S. District Court for the Northern District of Ohio, Tricaso operates the Better Living Clinic, currently located at 1236 Weathervane Lane, Suite 300, in Akron. He promotes the Better Living Clinic at gyms across Northeast Ohio and also serves as the “gym doctor” at a gym in Painesville. The full announcement may be accessed here.

Attorney General Jeff Sessions announced the unsealing of a 43-count indictment in federal court in Cleveland, Ohio, which charges two Chinese citizens with operating a conspiracy that manufactured and shipped deadly fentanyl analogues and 250 other drugs to at least 25 countries and 37 states. The indictment also alleges the drugs sold by the group directly led to the fatal overdoses of two people in Akron, Ohio. Fujing Zheng, aka Gordon Jin, 35, and his father Guanghua Zheng, 62, both of whom reside in Shanghai, China, are charged with conspiracy to manufacture and distribute controlled substances, conspiracy to import controlled substances into the United States, operating a continued criminal enterprise, money laundering and other crimes. The charges carry a potential sentence of life imprisonment because the drugs involved resulted in death, and the defendants’ conduct qualifies for an enhancement under the kingpin statute.

All New Jersey high schools will soon be required to carry life-saving opioid antidotes under a law signed by Gov. Phil Murphy on August 31, 2018. The law (A542), which takes effect December 1, 2018, will require governing bodies of public and private schools to develop policies for the emergency administration of an opioid antidote, based on guidelines from the state Department of Education.

Tennessee's largest health insurer will stop covering OxyContin prescriptions as part of several measures to combat opioid addiction. BlueCross BlueShield of Tennessee will encourage doctors to recommend two alternative opioid pain relievers, Xtampza (ex-TAMP'-zah) and Morphabond, which are designed to be more difficult to abuse. The insurer will cease paying for OxyContin on Jan. 1, 2019, vice president for pharmacy Natalie Tate stated. The suggested alternatives are more expensive than OxyContin, but customers will not have to pay for the copay. Tate said BlueCross will absorb the additional cost. "We are not telling our physicians you cannot prescribe this. We are not telling our members you cannot receive this," Tate said. "We are just drawing a line that we will not continue to pay for this and we have alternatives we have now put into place." BlueCross covers around 70 percent of insured Tennesseans. It's not the first to drop OxyContin, but it's among a select few that includes Cigna and Florida Blue. Cancer and hospice patients with approved prescriptions will be exempt from this coverage change.

The Drug Enforcement Administration announced action against a dangerous designer synthetic cathinone linked to 151 overdose deaths in the United States between 2015 and 2018. Published in the Federal Register, DEA’s action puts N-Ethylpentylone into Schedule I of the Controlled Substances Act. Schedule I substances refer to those with no legitimate, accepted medical or industrial use in the U.S. This action is based on a finding by the DEA Acting Administrator Uttam Dhillon that the placement of N-ethylpentylone in Schedule I is necessary to avoid an imminent hazard to the public safety. DEA published its Notice of Intent to take this action in June 2018. This temporary scheduling action lasts for 24 months, with an additional 12 months if necessary to conduct the necessary research to determine whether it should be controlled permanently. In 2017, DEA labs nationwide identified nearly 3,000 fentanyl and fentanyl-related compound exhibits, 922 synthetic cannabinoid exhibits, and 369 cathinone exhibits. Of the 369 cathinone exhibits submitted to DEA labs for testing and identification, 201 of those were N-Ethylpentylone. As a result of this order, the regulatory controls and administrative, civil and criminal sanctions applicable to Schedule I controlled substances will be imposed on persons who handle (manufacture, distribute, reverse distribute, import, export, engage in research, conduct instructional activities or chemical analysis or possess) or propose to handle N-ethylpentylone. N-Ethylpentylone is a synthetic cathinone of the phenethylamine class and it is similar to cathinone, methamphetamine, MDMA, and other Schedule I and II substances.

Medical/Marijuana/Synthetics

Oregon has instituted a new harvest notification policy and it is the first of its kind among states that have legalized marijuana. It is intended to ensure legally grown Oregon marijuana isn’t being transported out of state. Oregon rules allow applicants to have multiple licenses, permit out-of-state investment, and don’t cap grower licenses. The Oregon Liquor Control Commission, which regulates the state’s general use marijuana program, stopped accepting applications for new growing licenses in June so it could process a long backlog. The policy may be accessed here.

With millions of dollars in medical marijuana proceeds being moved across Pennsylvania monthly in unmarked cars, state banking regulators have appealed to leaders in Congress to create protections for financial institutions so that banks and credit unions might serve the state's cannabis industry. On August 31, 2018, Pennsylvania Governor Wolf’s administration sent a letter making the request to Congress' leaders: U.S. Reps. Paul Ryan (R., Wis.) and Nancy Pelosi (D., Calif.), and U.S. Sens. Mitch McConnell (R., Ky.) and Chuck Schumer (D., N.Y.). "We urge Congress to consider legislation that creates a safe harbor for financial institutions to serve a state-compliant business, or entrusts sovereign states with the full oversight and jurisdiction of marijuana-related activity," states the letter from Secretary of Banking and Securities Robin L. Wiessmann. State banking officials from Alaska, Connecticut, Hawaii, Louisiana, Michigan, Montana, Nevada, New York, Oklahoma, Oregon, and Washington State also signed the letter.

Methamphetamine

An Oklahoma woman pleaded guilty to manslaughter after her stillborn baby died from the toxicity of methamphetamine. Cherie Mason was sentenced to 12 years after she delivered a stillborn baby over a year ago that died from methamphetamine toxicity, according to the medical examiner. At the time, Mason had gone to the hospital after she could no longer feel the baby moving. Doctors removed the baby via C-Section after the baby was pronounced dead. She was 36 weeks pregnant at the time. Mason was initially charged with first-degree murder, but the charge was changed to manslaughter due to evidence in the case. She was also sentenced to attend a drug abuse program.

U.S. Customs and Border Protection officers at the World Trade Bridge in Laredo, Texas, seized a polydrug load of methamphetamine, heroin and fentanyl valued at $2.9 million, officials said. The seizure happened when a CBP officer referred a 2011 International Harvester tractor hauling a shipment of metal oil filters for an inspection. Hidden within the conveyance, CBP officers discovered 49 bags containing 131 pounds of methamphetamine, 15 bundles containing 34.61 pounds of heroin, four bundles containing 9.4 pounds of fentanyl and three bundles containing 6.87 pounds of acetaminophen with trace amounts of fentanyl.


Other

The National Highway Traffic Safety Administration (NHTSA) launched a new campaign called, "If You Feel Different, You Drive Different." "Drive High, Get a DUI." NHTSA has made fighting drugged driving a top priority, along with fighting drunk driving. Access more information about the campaign here.


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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