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Speaker 1: President Trump is going to declare widespread opioid abuse a

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Speaker 1: public health emergency today, but he will not make additional

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Speaker 1: federal money available to fight the epidemic. The opioid epidemic

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Speaker 1: has emerged as one of the nation's most pressing public

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Speaker 1: health matters, killing more than sixty four thousand Americans last year.

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Speaker 1: This falls short of declaring a national emergency, which would

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Speaker 1: have given states access to funding from the Federal Disaster

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Speaker 1: Relief Fund. Trump's Presidential Commission on the crisis had recommended

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Speaker 1: that action, and Trump indicated in August he would follow

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Speaker 1: that recommendation. The opioid crisis is an emergency, and I'm

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Speaker 1: saying officially right now it is an emergency. It's a

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Speaker 1: national emergency. We're going to spend a lot of time,

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Speaker 1: a lot of effort, and a lot of money on

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Speaker 1: the opioid dressing. The public health emergency last ninety days

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Speaker 1: and can be renewed indefinitely, joining us as Richard Austin

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Speaker 1: as a professor at the University of Kentucky School of Law. Richard,

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Speaker 1: what's the result of this declaration of public health emergency?

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Speaker 1: What happens next? Well, it's it's hard to say what

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Speaker 1: ultimately will happen. It's a good first step. Uh, it

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Speaker 1: comes a little late in the game. This has been

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Speaker 1: going on for at least fifteen years, but it is

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Speaker 1: nice that the federal government is finally taking it seriously. Richard.

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Speaker 1: How much more would would be be done if the

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Speaker 1: President had gone further and declared a national emergency? Well,

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Speaker 1: it sounds like the states would have been able to

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Speaker 1: apply for money to help with opioid addiction, and certainly

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Speaker 1: it's going to take a lot of money and a

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Speaker 1: lot of time to uh make a dent in that

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Speaker 1: in that problem, Richard. Would there be any downside to

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Speaker 1: declaring a national emergency besides the amount of funding, Well,

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Speaker 1: I don't see any downside it. I suppose you could.

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Speaker 1: You could argue that it's not an emergency like a

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Speaker 1: flood or or an earthquake or something like that. You

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Speaker 1: know that it's really a long term, very serious social problems.

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Speaker 1: So it isn't the sort of thing that a few

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Speaker 1: hundred million dollars at you know, at one fail swoop

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Speaker 1: is going to help much. Well, let's talk a little

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Speaker 1: bit about the things that actually will do. So, if

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Speaker 1: I understand it correctly, we're talking about wider access to

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Speaker 1: telemedicine services, UH, speeding up the hiring process to get

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Speaker 1: more people in place who can you can deal with

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Speaker 1: this problem. Let's uh local governments repurpose some funds. UH.

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Speaker 1: Which of those steps of any are gonna potentially have

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Speaker 1: a significant dent in this problem? Well, probably none of them.

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Speaker 1: None of them will have a significant UH dent or

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Speaker 1: making a significant dent. I mean, the trouble is, they

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Speaker 1: are millions of people who are addicted, and it's it's

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Speaker 1: going to take a few huge commitment of resources to

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Speaker 1: UH to deal with that problem. And I think it's

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Speaker 1: probably beyond the capability of the states to do it,

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Speaker 1: at least by themselves. UH. You know. The trouble is

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Speaker 1: that that we tend to attack problems of this sort

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Speaker 1: piece meal. So, for example, a few years ago, it

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Speaker 1: was shut down the pill mills UM and so a

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Speaker 1: lot of effort was focused in that direction and was

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Speaker 1: largely successful, but it didn't really cure the the overall problem.

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Speaker 1: People just turned to other drugs like heroin UH and

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Speaker 1: UH and other sources of supply, and so the problem

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Speaker 1: wasn't really alleviated very much, Richard, Because there have to

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Speaker 1: be a comprehensive legislative package from Congress with a dedicated

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Speaker 1: stream of funding, or are there other ways to approach

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Speaker 1: this Well, I think that that would be a good idea,

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Speaker 1: and perhaps it could be the foundation for an overall

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Speaker 1: comprehensive program. I mean, it can be totally federal, but

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Speaker 1: whatever long term solution there is, it's going to require

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Speaker 1: a lot of a lot of money. So the federal

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Speaker 1: government certainly has an important role to play in that respect.

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Speaker 1: Uh And of course uh uh, it can try to

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Speaker 1: regulate the drug companies, who are at least a part

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Speaker 1: of the source of the problem. Uh and uh for

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Speaker 1: focus on them. That might help some too. But it's

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Speaker 1: a very very complex problem, and there's probably no one

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Speaker 1: particular thing that's going to be the solution. It's going

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Speaker 1: to be a multitude of of of efforts. Uh and

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Speaker 1: and and it's going to be a long term project

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Speaker 1: as well. Richard, Don't we only have got a minute

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Speaker 1: left right right now, But you mentioned that that taking

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Speaker 1: the federal government a long time to get to this point.

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Speaker 1: It's been going on for fifteen years. Should we be

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Speaker 1: casting blame not just at at the Trump administration, but

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Speaker 1: at the Obama administration not moving more quickly on this. Well,

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Speaker 1: I think, I mean, there's certain parts of the federal government,

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Speaker 1: the UM certain U. S. Attorneys have been pretty aggressive

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Speaker 1: in going after the drug companies, bringing criminal proceedings against them.

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Speaker 1: Uh So it's not that the government hasn't done anything,

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Speaker 1: but it's sort of sad and ironic that Congress just,

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Speaker 1: uh not just but several months ago pasted legislation that

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Speaker 1: greatly reduced the drug the as enforcement powers against drug companies,

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Speaker 1: and it was passed unanimously, I might add, uh and

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Speaker 1: promptly signed by the president was President Obama at the time.

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Speaker 1: So they seemed to, uh go, they seem to be

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Speaker 1: ambivalent about how they want to approach the problem. President

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Speaker 1: Trump is going to declare widespread opioid abuse the public

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Speaker 1: health emergency today, but there's also a wave of government

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Speaker 1: lawsuits where states, counties, and cities have sued opioid makers

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Speaker 1: and distributors. There's all so a federal criminal investigation and

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Speaker 1: to produe farmers marketing of the opioid pain killer OxyContin,

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Speaker 1: and Insist Therapeutics founder John Kapoor and six other former

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Speaker 1: executives have been charged with conspiracy to him at fraud

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Speaker 1: by bribing doctors to prescribe the company's opioid pain drug.

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Speaker 1: Our guests are Richard Austiness, professor at the University of

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Speaker 1: Kentucky Law School, and Leo Belotowski, professor at Northeastern University

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Speaker 1: Law School. Leo, let's start with the government lawsuits. What's

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Speaker 1: the legal basis of the suits? Well, there's a number

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Speaker 1: of legal theories, um, you know, basically fraudalent marketing, and

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Speaker 1: a lot of consumer protection rules that are alleged to

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Speaker 1: be violated. Um. And you know, in many ways, these lawsuits,

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Speaker 1: in my view, are you know, somewhat late to the

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Speaker 1: late to the punch, um. You know. The From a

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Speaker 1: public health perspective, the crisis now is driven non by

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Speaker 1: pharmaceutical drugs, and although certainly industry practices deserve a lot

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Speaker 1: of scrutiny, um, you know, I doubt that these lawsuits

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Speaker 1: will make much of a doe in the current crisis

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Speaker 1: as it exists today. Richard, let me ask you about

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Speaker 1: this criminal investigation into Perdue Pharma. What do we know

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Speaker 1: based on either the civil lawsuits or or other news

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Speaker 1: reports about the allegations against Perdue And how hard will

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Speaker 1: it be for prosecutors to prove any sort of criminal wrongdoing. Well, um,

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Speaker 1: as I understand it. Uh. The basis for the for

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Speaker 1: these criminal proceedings is that the drug company misrepresented the

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Speaker 1: efficacy of the drug, saying it would last twelve hours,

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Speaker 1: when in fact it rarely did that. This is in

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Speaker 1: part due to the fact that it's sort of front loaded,

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Speaker 1: so you get most of the or a large part

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Speaker 1: of the opioid analgesic effect early in the in that

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Speaker 1: twelve hour period and it just sort of tapers off

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Speaker 1: to practically nothing by the end, so that means people

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Speaker 1: would start taking it taking a new dose sooner rather

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Speaker 1: than later. Uh and And it's alleged that Produced had

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Speaker 1: its sales reps misrepresent this, uh two doctors uh and

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Speaker 1: and so this is largely the the The interesting thing

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Speaker 1: is it's sort of like groundhog Day. They were led

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Speaker 1: guilty to essentially the same charges in two thousand and seven,

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Speaker 1: and we're fined a substantial amount of money, and it

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Speaker 1: looks like they're back at it again. And Leo produced

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Speaker 1: said that that it's misconduct that it pleaded guilty to

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Speaker 1: was only from through two thousand one, and then it

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Speaker 1: stopped and they regret what they did. Is there proof that, uh,

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Speaker 1: that you've seen or that you know of that the

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Speaker 1: FEDS have that it's still going on. I'm not you know,

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Speaker 1: I would not want to comment on whether or not

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Speaker 1: there's proof. I I don't know the case closely enough. UM.

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Speaker 1: I think that you know. Another aspect of this is, uh,

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Speaker 1: basically the allegation that produm misrepresented the risk of misuse

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Speaker 1: and addiction, which was for these long release UM formulations

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Speaker 1: was supposed to be lower and it and it appears

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Speaker 1: that perhaps it wasn't lower, and these drugs were made

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Speaker 1: out to be safer than than they were in fact. UM.

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Speaker 1: But you know, certainly, UM, there may have been continued

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Speaker 1: uh wrongdoing on the part of some representatives who continued

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Speaker 1: to essentially make claims about the medication that we're not

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Speaker 1: we're not rooted in the evidence. Richard, What is the

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Speaker 1: fact that that there might be ongoing wrong doing? Tell

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Speaker 1: us about that earlier plea agreement? I mean usually, I

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Speaker 1: think plea agreements have provisions in them that try to

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Speaker 1: make sure that the defendant doesn't doesn't repeat the behavior. UH.

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Speaker 1: Can we infer can we imagine that maybe that that

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Speaker 1: agreement wasn't tough enough one perdue. Well, I'm not sure that.

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Speaker 1: I'm sure there was a memor memorandum of agreement. That's uh.

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Speaker 1: And I think the interesting aspect of this, and I

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Speaker 1: don't know the answer, is how long it was supposed

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Speaker 1: to last. It's not necessarily forever, So once the scrutiny

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Speaker 1: was off, they may have reverted back to what they

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Speaker 1: were doing before. At least that seems to be what

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Speaker 1: the government is alleging. Leo. There are all kinds of

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Speaker 1: problems with the opioid crisis. There's addiction, there's treatment, there's

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Speaker 1: regulatory policy, enforcement, all kinds of different things. Is there

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Speaker 1: one area that you would cite as the most important

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Speaker 1: to handle immediately? And you have about forty seconds here? Sure,

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Speaker 1: I think, uh, you know, first, stop people from dying

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Speaker 1: when they order, so, making sure that people are revived

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Speaker 1: and receive help, and that, you know, moving upstream, making

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Speaker 1: sure that people have access to adequate and evidence space

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Speaker 1: drug treatment. Those are the two top priorities to sort

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Speaker 1: of bend the curve right now, Richard, Do you want

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Speaker 1: to mention your top priority in your mind? Well, I'm

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Speaker 1: not sure what that would be, but I would say

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Speaker 1: that the litigation, the civil litigation that you spoke of earlier,

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Speaker 1: is probably not going to be uh much of a

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Speaker 1: much of a solution. It might enrich state governments, but

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Speaker 1: I don't know if it's going to do very much

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Speaker 1: to alleviate the obioid crisis. Thank you both for being

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Speaker 1: on Bloomberg Law. That's Richard Ousiness, a professor at the

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Speaker 1: University of Kentucky School of Law, and Leo Biletsky, professor

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Speaker 1: at Northeastern University Law School, coming up on Bloomberg Law.

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Speaker 1: A federal judge has rejected a request from eighteen states

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Speaker 1: and d C to force the Trump administration to resume

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Speaker 1: paying Obamacare subsidies, so called cost sharing reduction payments to

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Speaker 1: health insurers. This is Bloomberg