drugs

Addiction medication company reported pushing product through legislation, donating to TN legislators

Alkermes, a company that makes an addiction treatment medication called Vivitrol, has been pushing legislation at the state level that would give its product a preference over others, according to a National Public Radio report. At the same time, affliliate WPLN reports that the Alkermes donated more than $20,000 to Tennessee legislators last year.

State records show Alkermes registered four lobbyists for this year’s Tennessee legislative session. The company’s PAC registered to make state-level donations late in 2015, beginning actual donations in January of 2016.

There were several bills filed this year dealing with addiction treatment – including some that appear to be placeholder “caption bills” designed to be amended later. But a quick skim of legislative records indicates none advanced out of committee.

The NPR report – bearing the headline “A Drugmaker Tries To Cash In On The Opioid Epidemic, One State Law At A Time” — focuses on Indiana, where a registered Alkermes lobbyist, who also heads a mental health advocacy group, drafted a bill that was approved after what some thought was a misleading promotional effort. Excerpt:

He said the legislation would move the state “toward evidence-based treatment.”

But the bill wouldn’t do that. Instead, it would cement rules making it harder to access certain addiction medications — medications that many patients rely on. The goal was to steer doctors toward a specific brand-name drug: Vivitrol.

… His efforts have helped turn Indiana into what Alkermes describes in investor documents as an “up-and-coming” state, where the drug’s sales are poised to jump dramatically.

McCaffrey’s work promoting Vivitrol via legislation in Indiana is part of a larger pattern. An investigation by NPR and Side Effects Public Media has found that in statehouses across the country, and in Congress, Alkermes is pushing Vivitrol while contributing to misconceptions and stigma about other medications used to treat opioid addiction.

From WPLN:

In Tennessee, Alkermes has made 30 contributions to Democratic and Republican lawmakers and to political action committees. All of those were between January of last year and the November election. The company has also hired lobbyists.

It’s not clear, though, this early-stage political push has been persuasive. Marie Williams, commissioner of the Tennessee Department of Mental Health and Substance Abuse Services, says Vivitrol can be an effective treatment for some opioid abusers, but Tennessee doesn’t prefer it to other therapies.

“What we want is for people to get avenues of treatment, and we are for any avenue that will help you get into recovery and stay in recovery,” she says.

But, state officials add, drug courts are using Vivitrol more often. And that’s where many decisions about treatment are made.

Note: House Speaker Beth Harwell, who recently urged Attorney General Herbert Slatery to file a lawsuit against manufacturers of opioid drugs, was one of the bigger beneficiaries of Alkermes donations — $1,000 to her reelection campaign and $500 to her leadership PAC.

The Alkermes PAC on June 6 filed an amended version of its 4th quarter 2016 disclosure with the Registry of Election Finance that appears to duplicate most of the donations listed in a previous disclosure. (The duplication’s are not included in reaching the count of more than $20,000 to 30 legislators and PACs.)  Drew Rawlins, executive director of the Bureau of Ethics and Campaign Finance,  says via email that the Registry has sent a letter asking for clarification of the filing.

Slatery investigating opioid manufacturers, looking to ‘decisive action’ at ‘the appropriate time’

News release from Tennessee Office of the Attorney General

Attorney General Herbert H. Slatery III today announced Tennessee is one state leading a bipartisan coalition of a majority of Attorneys General from across the country as part of an effort to combat the opioid epidemic. The Attorneys General are conducting comprehensive investigations into the widespread prescribing and use of opioids, as well as the role parties involved in the manufacture and distribution of opioids may have played in creating or prolonging this problem.

A focus of the ongoing investigation is to evaluate whether manufacturers have engaged in unlawful practices in the marketing and sale of opioids. The Attorneys General are committed to using the vast investigative resources available, including subpoenas for documents and testimony, to identify and hold accountable those parties responsible for the opioid epidemic.

“There is not a single community in Tennessee, or a region of the country for that matter, that has not witnessed the devastating impact of opioid abuse,” General Slatery said. “At the appropriate time, you can be assured Tennessee will take decisive action against those parties responsible for harming so many families.”

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DAs in three Northeast TN counties file lawsuit against opioid manufacturers

A lawsuit was filed against three opioid manufacturers by district attorneys general representing three Northeast Tennessee counties on Tuesday with a drug-addicted infant, designated as “Baby Doe,” also listed as a plaintiff, reports the Kingsport Times News.

It’s the first such lawsuit filed by governmental officials in Tennessee, though state Attorney General Herbert Slaterly has been publicly urged to sue by House Speaker Beth Harwell – Ohio’s attorney general already has – while officials in Shelby County and elsewhere have been talking up the idea. (Previous post HERE; Commercial Appeal story on the Shelby talk HERE.)

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Healthcare workers refusing a drug test can lose licenses under new law

Gov. Bill Haslam signed into law a bill that will require any healthcare worker who refuses to submit to a drug test or tests positive without a valid prescription to report to a substance abuse peer assistance or treatment program, reports WJHL TV.

The bill (HB1067, as amended) was signed Tuesday, according to the legislative website. It was sponsors by Sen. Rusty Crowe, R-Johnson City, and Rep.  John Holsclaw, R-Elizabethton, and passed both chambers unanimously.

The law allows those battling addiction to complete treatment and then return to work. However, those who don’t fulfill treatment requirements will face suspension of their licenses.

… “This is probably one of the most important bills that the health committee passed this year. It’s going to protect patients,” sponsor Sen. Rusty Crowe (R), TN-District 3, said Tuesday. “It’s going to separate the patient from the practitioner that’s addicted and for the first time, we will now know who they are without having to wait on a complaint, which means somebody’s been hurt.”

Harwell urges AG to sue opioid drug manufacturers

House Speaker Beth Harwell has asked Tennessee Attorney General Herbert Slatery to consider filing a lawsuit against five manufacturers of prescription opioid drugs – as Ohio Attorney General Mike DeWine did earlier this week.

Harwell’s letter to Slatery says Tennessee is “consistently ranked among the worst states” for the opioid abuse and notes the Ohio lawsuit contends the drug manufacturers “sparked the addiction crisis by misrepresenting the drugs’ addictive qualities.”

Further from WKRN:

“We have a true crisis in our state,” said… Harwell. “And we want to address it… To some extent, drug manufacturers have misled how addictive these prescriptions are.”

Speaker Harwell said she’ll defer to the Attorney General to decide if a lawsuit is necessary. Harwell also stated she does hope that if a lawsuit is filed by the state. If the court sides with the state, the money would go toward helping people battling addiction.

“Really what we’re looking for is some assistance in helping people go through rehabilitation programs and to pay for those programs,” Harwell said. “To help them come off of what is really a crisis.”

From an AP brief on the letter:

The companies sued by DeWine are Purdue Pharma; Endo Health Solutions; Teva Pharmaceutical Industries and its subsidiary, Cephalon; Johnson & Johnson and its subsidiary, Janssen Pharmaceuticals; and Allergan.

And here’s a statement via email from Attorney General Slatery: “Ohio advised us that it was taking this step.  It is hard to overstate the problem that opioid abuse is in our State and nationally.  We have been working for quite some time with the Department of Health and the Department of Mental Health and Substance Abuse Services, and frankly other states, to determine the most effective role our Office can play in addressing and helping to resolve this problem.”

A copy of the letter is available by clicking on this link: harwellletter

On ‘Big Pharma’ lobbying clout in TN

A proposal to require that pharmaceutical companies notify state officials when they increase the cost of chemotherapy medication by more than 10 percent ran into opposition in a House committee, triggering an outburst against drug company lobbyists from Rep. Joe Towns, D-Memphis, reports the Memphis Daily News.

The proposal came in the form of an amendment offered by Rep. Bill Beck, D-Nashville, to a bill (HB1059) sponsored by Rep. William Lamberth, R-Cottontown, when it came up in the House Insurance and Banking Committee. The measure, as filed, would prohibit an insurance provider from requiring a higher co-payment for oral anticancer medication than for injected chemotherapy medication.

“What chapped me is these damn lobbyists, these pharmaceutical people and the people that think they run this building – and nobody’s voted for them – guaranteeing if you do this and put an amendment on it they’re going to kill the damn bill. That’s what I don’t like,” Towns says.

… “Nobody’s voted for them sapsuckers, and they don’t have the power, nor should they have the power unless these jokers (lawmakers) acquiesce,” Towns says. “So my concern was that they need to have some courage and to stand up and they need to get this health care cost in terms of medicine and pharmaceuticals under control, because there’s greed, there’s been greed and there will continue to be greed if there ain’t no courage by these members.”

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Push for legalizing medical marijuana dropped for the year

Rep. Jeremy Faison, a leading advocate for legalizing use of marijuana for medical purposes, is abandoning the effort for this year and says that House Speaker Beth Harwell and Lt. Gov. Randy McNally have agreed to form a task force to study the issue over the coming months.

The House Health Committee rejected Tuesday a non-binding resolution (HJR65) by Rep.  Sabi ‘Doc’ Kumar, R-Springfield, that declared support for use of “government-approved marijuana plant products for medicinal purposes.”

Kumar’s resolution was officially deferred to “summer study” on voice vote – Faison made the motion — after testimony from advocates of medical marijuana use and Dr. Michael Warren, deputy commissioner of the Department of Health, who said he supported “the spirit” of the non-binding resolution.

Faison, R-Cosby, said during the hearing that he thought the resolution was “muddying the water” by suggesting Tennessee use should await Federal Food and Drug Administration approval, a process that could take years.

The legislator took his separate bill (HB495) – filed as a caption bill and still awaiting an amendment to spell out details on legalizing medicinal marijuana on the legislative website  — “off notice,” meaning no vote is scheduled.

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84 TN welfare applicants have failed drug tests since 2014

Tennessee started drug testing some applicants for welfare benefits under the Temporary Assistance for Needy Families program in 2014, in accord with a law approved by the Legislature two years earlier, and since then 84 people have failed the tests, administered at a cost of $38,934, reports WSMV-TV.

“Is this law working?” asked reporter Alanna Autler.

“I don’t know if it’s working the way it was written in the sense we’re being compliant with the way it’s written,” said Stephanie Jarnagin, with the Tennessee Department of Human Services. “But I don’t think it’s up for us to decide whether or not it’s good policy necessarily.”

… More than 54,835 people applied for TANF in Tennessee between when the law passed in 2014 and Dec. 31 of last year. During that same time period, 814 people were flagged to be drug tested. Of that pool, 84 people failed the drug test.

… Jarnagin said 167 people have abandoned the application process since 2014 when the law took effect. But she said DHS has no idea why people walk away, and the reasons could range from moving out of states to a change in financial circumstance.

… Failing a drug test doesn’t necessarily mean that applicants lose their shot at TANF benefits. The applicant can go through a drug treatment program, which they must pay for.

In the event the state does deny an applicant benefits, the cash assistance can still be given to the applicant’s family. In 16 cases, benefits were routed to children through a protected pay play, Jarnagin said.

Jarnagin added it’s inaccurate to think this law saves money since any denied benefits would go back to helping other recipients. She said currently there is neither a waiting list nor a backlog for benefits.

The report includes comments from House Majority Leader Glen Casada in support of the law and from Senate Democratic Caucus Chairman Jeff Yarbro saying it needs to be reexamined and “maybe we need to go a different route.”

Harwell sets up task force on prescription drug abuse

News release from House Speaker’s office

NASHVILLE — Speaker Beth Harwell (R-Nashville) this week created a task force on opioid and prescription drug abuse. The task force’s immediate goal will be to work on legislation, but its efforts will be ongoing to determine the best strategies for tackling the opioid epidemic. Tennessee is consistently ranked at the top of the charts nationally with regards to prescription drug abuse.

“This task force presents an opportunity to have a very serious conversation about opioid and prescription drug abuse in our state,” said Speaker Harwell. “The statistics are devastating: there are more opioid prescriptions than there are people in Tennessee. In 2015, 1,451 Tennesseans died from drug overdoses, the highest annual number in our state’s history. And the number of babies born who have been chronically exposed to opioids is high, particularly in East Tennessee. The Tennessee Department of Health reports that from 2000 to 2012, the rate of babies born with exposure increased 15 fold. We can, and should, do more to ensure this is not happening.”

She continued, “The Tennessee General Assembly has passed some legislation in the past targeting the problem, but I believe we also need to look toward solutions that include treatment and prevention measures. I believe this task force can be an asset as we work to address this issue in this session and in the future.”

The Centers for Disease Control estimates that prescription opioid abuse has a total economic burden of $78.5 billion per year in the United States. There is an estimated $7.7 billion criminal justice cost across the country.

Speaker Harwell appointed the following members to the task force:

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Dickerson, Faison outline new TN medical marijuana bill for 2017

Sen. Steve Dickerson of Nashville and Rep. Jeremy Faison of Cosby, who unsuccessfully pushed legislation last session to legalize marijuana for medical purposes in Tennessee, say they’ll try again in 2017 with a modified bill. It allows marijuana to be used in treatment of specified ailments, upon a doctor’s recommendation, applies a state tax to sales and sets up a licensing system for growing and selling marijuana.

The two Republicans presented the proposal at a news conference Wednesday, flanked by supporters including retired police officers, children, veterans and musicians, reports The Tennessean.

And WPLN says they stressed the need for Tennesseans to convince reluctant lawmakers to back the bill, something that they think should be easier than the last time such a bill came up. Two dozen other states had legalized marijuana for medicinal purposes and a few have decriminalized possession generally.

“Having now gone through this for a second time, I find the conversations to be much easier,” he said. “I find the resistance to be diminishing.”

…(The legislators) hope to convince fellow Republicans by highlighting medical marijuana as an alternative to addictive opioids.

But they say the real persuasion will happen through individuals telling lawmakers their stories. At a press conference Wednesday, Faison pointed to a 2-year-old girl with epilepsy whose parents convinced him to support the cause.

“We have an uphill battle with a lot of our colleagues,” he said. “They have believed something their whole life, and it’s very difficult to get out of your comfort zone.”

Note: An outline of the bill, as prepared by sponsors, is below. It has not yet been filed.

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