The U.S.’s biggest drug distributors and some of its most senior politicians colluded to fuel the country’s opioid epidemic, leading directly to thousands of unnecessary deaths.
That was the conclusion of a former Drug Enforcement Agency official whose blistering testimony was carried on last night’s edition of 60 Minutes on CBS and in the Washington Post, which also participated in the investigation.
“This is an industry that’s out of control. If they don’t follow the law in drug supply, and diversion occurs, people die. That’s just it, people die,” Joe Rannazzisi, the former DEA agent turned whistleblower, told CBS. He’s now advising lawyers suing the opioid industry.
Rannazzisi singled out the country’s three biggest drug distribution companies for criticism: Cardinal Health (CAH), McKesson (MCK) and AmerisourceBergen (ABC). Together the three account for almost 90 percent of their market, he explained.
Bill Whitaker said he was implying that “these big companies knew that they were pumping drugs into American communities that were killing people.”
“That’s not an implication, that’s a fact,” Rannazzisi replied. “That’s exactly what they did…This is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors’ offices that distributed them out to people who had no legitimate need for those drugs.”
McKesson didn’t respond immediately to the allegations. Cardinal issued a statement saying that: “Our people care deeply about this issue and the devastation it has caused American families and communities. We will continue to work alongside regulators, manufacturers, prescribers, pharmacists, educators, patients and others to fight opioid abuse and addiction.” (For the full statement, click here).
AmerisourceBergen CEO Steve Collis argued in a recent blog post that distributors merely execute what is demanded from pharmacies and approved by the DEA.
“We report the quantity and details of every order of opioid-based medication we ship directly to the DEA on a daily basis,” Collis wrote. “We use complex algorithms to identify and stop orders that are deemed to be suspicious. In fact, we’ve reported and stopped tens of thousands of suspicious orders since 2007, not to mention the countless other orders that pharmacies never had the opportunity to place because we declined to service them altogether.”
The Healthcare Distribution Alliance, an industry lobby group, meanwhile argued in a statement that it had been raising concerns about prescription of painkillers for years but the DEA had failed to respond.
“Our industry has continuously sought opportunities to communicate and coordinate more effectively with DEA to better understand our reporting responsibilities under the Controlled Substances Act, and to work together to mitigate the opioid epidemic,” the HDA said. “Prior to 2016, these efforts were not reciprocated — as noted by the Government Accountability Office (GAO) in a July 2015 report.”
A law signed by then-president Barack Obama last year made it much more difficult for the Drug Enforcement Agency (DEA) to crack down on the illegal distribution and sale of prescription painkillers such as Vicodin and oxycodone, the investigation found.
The law in question, the Ensuring Patient Access and Effective Drug Enforcement Act, was championed by Republican congressman Tom Marino and—according to the story—largely written by D. Linden Barber, a former DEA lawyer who went on to work for the drug companies. Marino is currently Donald Trump’s pick to head the Office of National Drug Control Policy.
The law was supposed to aid enforcement by improving ties with industry. However, it made a crucial change to the standard required for the DEA to freeze drug shipments that it suspected were finding their way to addicts in opioid-ravaged communities. For four decades, the DEA could freeze shipments that posed an “imminent danger,” but the law changed that to “a substantial likelihood of an immediate threat.”
The Washington Post noted that, in a draft article written for the Marquette Law Review, DEA chief administrative law judge John Mulrooney said the law “imposed a dramatic diminution of the agency’s authority” that made it “all but logically impossible” to stop a drug company distributing its wares for non-compliance with federal law.
According to the article, the White House did not appreciate the impact of the change when Obama signed the law. However, despite the fact that the opioid epidemic has reached the level of “national emergency,” not one order has been made against a distributor or manufacturer since late 2015.
The Post said it is currently suing the Justice Department to get its hands on public records that might clarify what happened.
The DEA said Monday that it was doing everything it could to fight the opioid epidemic. “During the past seven years, we have removed approximately 900 registrations annually, preventing reckless doctors and rogue businesses from making an already troubling problem worse,” it said in a statement. CBS also reported that the Justice Department did not dispute any of the 60 Minutes story.
UPDATE: This article has been updated to include comment from AmerisourceBergen and the HDA.