Via Naked Capitalism

By Jerri-Lynn Scofield, who has worked as a securities lawyer and a derivatives trader. She is currently writing a book about textile artisans.

The Wall Street Journal reported yesterday that Federal prosecutors have initiated an investigation into whether six drug companies have intentionally allowed opioids to flow into communities, Federal Prosecutors Launch Criminal Probe of Opioid Makers, Distributors:

The investigation, if it results in criminal charges, could become the largest prosecution yet of drug companies alleged to have contributed to the opioid epidemic, escalating the legal troubles of businesses that already face complex, multibillion-dollar civil litigation in courts across the country. Prosecutors are examining whether the companies violated the federal Controlled Substances Act, a statute that federal prosecutors have begun using against opioid makers and distributors this year.

By using statutes typically used to target drug dealers, prosecutors are finally seeing these companies for what they are: drug pushers. This approach is unusual but not unprecedented, according to the Journal:

Earlier this year, federal prosecutors filed major criminal cases in Manhattan and Ohio that, for the first time, employed criminal statutes that are more commonly applied to drug dealers, legal experts say.

When prosecutors from the Southern District of New York announced criminal charges against a pharmaceutical distributor and two executives earlier this year, the Manhattan U.S. attorney’s office said the case was unusual.

“This prosecution is the first of its kind,” Manhattan U.S. Attorney Geoffrey Berman said in April, “executives of a pharmaceutical distributor and the distributor itself have been charged with drug trafficking.”

CNBC notes in Federal prosecutors open criminal probe of opioid makers and distributors, report says:

The investigation marks a significant broadening of the federal government’s focus on pinpointing which parties contributed to the opioid crisis.

The six companies to receive subpoenas from the US attorney’s office for the eastern district of New York are: AmerisourceBergen Corp., Amneal Pharmaceuticals Inc., Johnson & Johnson, Mallinckrodt, McKesson Corp. and Teva Pharmaceutical Industries Ltd., as reported by the WSJ, citing regulatory filings.

This investigation is in its early stages; whether or not other companies have thus far also received subpoenas is not apparent. As federal prosecutors proceed, they will likely widen their probe, drawing in more companies and individuals.

Separately, most states, as well as roughly 2,600 city, county, and municipal governments have sued major players throughout the opioids supply chain. Despite intense pressure on parties to settle, these negotiations have stalled and numerous lawsuits remain pending(see Four Companies Settle Just Before Bellwether Opioids Trial Was to Begin Today in Ohio.)

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One manufacturer, Purdue Pharma has already filed for bankruptcy (see Purdue Files for Bankruptcy, Agrees to Settle Some Pending Opioids Litigation: Sacklers on Hook for Billions?).

As yesterday’s WSJ further reports:

…Purdue separately faces civil and criminal probes from the U.S. attorneys offices in New Jersey, Vermont and Connecticut and U.S. Justice Department in Washington and has said that a proposed plan to turn over its operations to creditors is contingent on resolving the federal investigations.

Opioids have made it onto Trump’s personal radar screen. AP reports in Trump donates 3rd-quarter salary to help fight opioid crisis:

President Donald Trump is donating his third-quarter salary to help tackle the nation’s opioid epidemic.

A White House official says Trump has given the $100,000 he would be paid in the quarter to the Office of the Assistant Secretary of Health, which oversees federal public health offices and programs, including the surgeon general’s office.

The White House says the funds are being earmarked “to continue the ongoing fight against the opioid crisis.”

Jerri- Lynn here. Well. Thanks for your concern!!

More from AP:

Trump has made tackling the misuse of opioids an administration priority. More than 70,000 Americans died in 2017 from drug overdoses, the bulk of them involving opioids.

Trump is required to be paid, but he has pledged to donate his salary while in office to worthy causes. Trump donated his second-quarter salary to the surgeon general’s office.

This I didn’t know.

Deaths of Despair

In separate news today, the Journal of the American Medical Association (JAMA) published a study affirming that American life expectancy continues to decline, Life Expectancy and Mortality Rates in the United States, 1959-2017 .

The US trend is in contrast to the state of play in other advanced countries; US life expectancy began to lose pace in the 1980s, according to the JAMA study, and by 1998, had declined to a level below the OECD average. Since 2014, US life expectancy rates have declined for three consecutive years.

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Naked Capitalism has covered the rise in “deaths of despair” extensively: the decline in US life expectancy, especially  for poorer and less educated Americans, see these posts drawn from numerous examples: Stunning” Rise in Death Rate, Pain Levels for Middle-Aged, Less Educated Whites); Credentialism and Corruption: The Opioid Epidemic and “the Looting Professional Class”; US Life Expectancy Declines in 2015: Unintentional Injuries Rise; and American Life Expectancy Continues to Fall: Rise in Suicides, Overdose Deaths the Big Culprit.

The latest JAMA figures show that the decline extends throughout the country, as the New York Times reports in It’s Not Just Poor White People Driving a Decline in Life Expectancy:

But a new analysis of more than a half-century of federal mortality data, published on Tuesday in JAMA, found that the increased death rates among people in midlife extended to all racial and ethnic groups, and to suburbs and cities. And while suicides, drug overdoses and alcoholism were the main causes, other medical conditions, including heart disease, strokes and chronic obstructive pulmonary disease, also contributed, the authors reported.

From the JAMA study’s abstract:

Findings  Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states.

This trend has occurred despite the US spending the highest per capita on health  of any country in the world – a point made in a JAMA editorial published simultaneously with the study, Confronting the Rise and Fall of US Life Expectancy.

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Now, no one would dispute that the US health care system is a mess. From the NYT:

“The whole country is at a health disadvantage compared to other wealthy nations,” the study’s lead author, Dr. Steven Woolf of Virginia Commonwealth University, said. “We are losing people in the most productive period of their lives. Children are losing parents. Employers have a sicker work force.”

The study makes for depressing reading; you can download the full version for free by registering at the above link.

If you lack time for that, some summary from the NYT:

“Mortality has improved year to year over the course of the 20th century,” said Dr. Samuel Preston, a demographer at the University of Pennsylvania. “The 21st century is a major exception. Since 2010 there’s been no improvement in mortality among working-aged people.”

Death rates are actually improving among children and older Americans, Dr. Woolf noted, perhaps because they may have more reliable health care — Medicaid for many children and Medicare for older people. Jerri-Lynn here: my emphasis.

But the problem isn’t wholly related to the dysfunctional US health care system. Extreme inequality doesn’t just harm the poorest and weakest among us. Over to the NYT:

“The fact that it’s so expansive and involves so many causes of death — it’s saying that there’s something broader going on in our country,” said Ellen R. Meara, a professor of health policy at Dartmouth College. “This no longer limited to middle-aged whites.”

The states with the greatest relative increases in death rates among young and middle-aged adults were New Hampshire, Maine, Vermont, West Virginia and Ohio.

Dr. Woolf said one of the findings showed that the excess deaths were highly concentrated geographically, with fully a third of them in just four states: Ohio, Pennsylvania, Kentucky and Indiana.

“What’s not lost on us is what is going on in those states,” he said. “The history of when this health trend started happens to coincide with when these economic shifts began — the loss of manufacturing jobs and closure of steel mills and auto plants.”

What do the billionaires and their toadies have to say to that?

And, to return to where I began, note that Ohio is ground zero for the opioids epidemic.


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