WEBVTT - Purdue Targeted as Trump Declares Opioid Emergency (Audio)

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<v Speaker 1>President Trump is going to declare widespread opioid abuse a

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<v Speaker 1>public health emergency today, but he will not make additional

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<v Speaker 1>federal money available to fight the epidemic. The opioid epidemic

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<v Speaker 1>has emerged as one of the nation's most pressing public

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<v Speaker 1>health matters, killing more than sixty four thousand Americans last year.

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<v Speaker 1>This falls short of declaring a national emergency, which would

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<v Speaker 1>have given states access to funding from the Federal Disaster

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<v Speaker 1>Relief Fund. Trump's Presidential Commission on the crisis had recommended

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<v Speaker 1>that action, and Trump indicated in August he would follow

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

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<v Speaker 1>saying officially right now it is an emergency. It's a

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

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<v Speaker 1>a lot of effort, and a lot of money on

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<v Speaker 1>the opioid dressing. The public health emergency last ninety days

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<v Speaker 1>and can be renewed indefinitely, joining us as Richard Austin

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<v Speaker 1>as a professor at the University of Kentucky School of Law. Richard,

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<v Speaker 1>what's the result of this declaration of public health emergency?

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<v Speaker 1>What happens next? Well, it's it's hard to say what

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

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<v Speaker 1>comes a little late in the game. This has been

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<v Speaker 1>going on for at least fifteen years, but it is

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<v Speaker 1>nice that the federal government is finally taking it seriously. Richard.

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<v Speaker 1>How much more would would be be done if the

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<v Speaker 1>President had gone further and declared a national emergency? Well,

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<v Speaker 1>it sounds like the states would have been able to

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<v Speaker 1>apply for money to help with opioid addiction, and certainly

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<v Speaker 1>it's going to take a lot of money and a

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<v Speaker 1>lot of time to uh make a dent in that

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<v Speaker 1>in that problem, Richard. Would there be any downside to

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<v Speaker 1>declaring a national emergency besides the amount of funding, Well,

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<v Speaker 1>I don't see any downside it. I suppose you could.

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<v Speaker 1>You could argue that it's not an emergency like a

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<v Speaker 1>flood or or an earthquake or something like that. You

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

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<v Speaker 1>So it isn't the sort of thing that a few

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<v Speaker 1>hundred million dollars at you know, at one fail swoop

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

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<v Speaker 1>bit about the things that actually will do. So, if

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<v Speaker 1>I understand it correctly, we're talking about wider access to

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<v Speaker 1>telemedicine services, UH, speeding up the hiring process to get

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<v Speaker 1>more people in place who can you can deal with

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<v Speaker 1>this problem. Let's uh local governments repurpose some funds. UH.

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<v Speaker 1>Which of those steps of any are gonna potentially have

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

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<v Speaker 1>None of them will have a significant UH dent or

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<v Speaker 1>making a significant dent. I mean, the trouble is, they

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<v Speaker 1>are millions of people who are addicted, and it's it's

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<v Speaker 1>going to take a few huge commitment of resources to

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<v Speaker 1>UH to deal with that problem. And I think it's

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<v Speaker 1>probably beyond the capability of the states to do it,

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<v Speaker 1>at least by themselves. UH. You know. The trouble is

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<v Speaker 1>that that we tend to attack problems of this sort

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<v Speaker 1>piece meal. So, for example, a few years ago, it

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<v Speaker 1>was shut down the pill mills UM and so a

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<v Speaker 1>lot of effort was focused in that direction and was

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

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<v Speaker 1>People just turned to other drugs like heroin UH and

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<v Speaker 1>UH and other sources of supply, and so the problem

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<v Speaker 1>wasn't really alleviated very much, Richard, Because there have to

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<v Speaker 1>be a comprehensive legislative package from Congress with a dedicated

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<v Speaker 1>stream of funding, or are there other ways to approach

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<v Speaker 1>this Well, I think that that would be a good idea,

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<v Speaker 1>and perhaps it could be the foundation for an overall

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<v Speaker 1>comprehensive program. I mean, it can be totally federal, but

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<v Speaker 1>whatever long term solution there is, it's going to require

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<v Speaker 1>a lot of a lot of money. So the federal

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<v Speaker 1>government certainly has an important role to play in that respect.

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<v Speaker 1>Uh And of course uh uh, it can try to

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<v Speaker 1>regulate the drug companies, who are at least a part

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<v Speaker 1>of the source of the problem. Uh and uh for

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<v Speaker 1>focus on them. That might help some too. But it's

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<v Speaker 1>a very very complex problem, and there's probably no one

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<v Speaker 1>particular thing that's going to be the solution. It's going

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<v Speaker 1>to be a multitude of of of efforts. Uh and

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<v Speaker 1>and and it's going to be a long term project

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

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<v Speaker 1>left right right now, But you mentioned that that taking

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<v Speaker 1>the federal government a long time to get to this point.

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<v Speaker 1>It's been going on for fifteen years. Should we be

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<v Speaker 1>casting blame not just at at the Trump administration, but

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<v Speaker 1>at the Obama administration not moving more quickly on this. Well,

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<v Speaker 1>I think, I mean, there's certain parts of the federal government,

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<v Speaker 1>the UM certain U. S. Attorneys have been pretty aggressive

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<v Speaker 1>in going after the drug companies, bringing criminal proceedings against them.

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

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<v Speaker 1>but it's sort of sad and ironic that Congress just,

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<v Speaker 1>uh not just but several months ago pasted legislation that

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<v Speaker 1>greatly reduced the drug the as enforcement powers against drug companies,

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<v Speaker 1>and it was passed unanimously, I might add, uh and

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<v Speaker 1>promptly signed by the president was President Obama at the time.

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<v Speaker 1>So they seemed to, uh go, they seem to be

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<v Speaker 1>ambivalent about how they want to approach the problem. President

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<v Speaker 1>Trump is going to declare widespread opioid abuse the public

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<v Speaker 1>health emergency today, but there's also a wave of government

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<v Speaker 1>lawsuits where states, counties, and cities have sued opioid makers

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<v Speaker 1>and distributors. There's all so a federal criminal investigation and

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<v Speaker 1>to produe farmers marketing of the opioid pain killer OxyContin,

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<v Speaker 1>and Insist Therapeutics founder John Kapoor and six other former

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<v Speaker 1>executives have been charged with conspiracy to him at fraud

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<v Speaker 1>by bribing doctors to prescribe the company's opioid pain drug.

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<v Speaker 1>Our guests are Richard Austiness, professor at the University of

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<v Speaker 1>Kentucky Law School, and Leo Belotowski, professor at Northeastern University

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

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<v Speaker 1>the legal basis of the suits? Well, there's a number

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<v Speaker 1>of legal theories, um, you know, basically fraudalent marketing, and

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<v Speaker 1>a lot of consumer protection rules that are alleged to

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<v Speaker 1>be violated. Um. And you know, in many ways, these lawsuits,

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<v Speaker 1>in my view, are you know, somewhat late to the

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<v Speaker 1>late to the punch, um. You know. The From a

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<v Speaker 1>public health perspective, the crisis now is driven non by

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<v Speaker 1>pharmaceutical drugs, and although certainly industry practices deserve a lot

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<v Speaker 1>of scrutiny, um, you know, I doubt that these lawsuits

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<v Speaker 1>will make much of a doe in the current crisis

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<v Speaker 1>as it exists today. Richard, let me ask you about

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<v Speaker 1>this criminal investigation into Perdue Pharma. What do we know

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<v Speaker 1>based on either the civil lawsuits or or other news

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<v Speaker 1>reports about the allegations against Perdue And how hard will

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

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<v Speaker 1>as I understand it. Uh. The basis for the for

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<v Speaker 1>these criminal proceedings is that the drug company misrepresented the

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<v Speaker 1>efficacy of the drug, saying it would last twelve hours,

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<v Speaker 1>when in fact it rarely did that. This is in

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

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<v Speaker 1>so you get most of the or a large part

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<v Speaker 1>of the opioid analgesic effect early in the in that

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<v Speaker 1>twelve hour period and it just sort of tapers off

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<v Speaker 1>to practically nothing by the end, so that means people

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<v Speaker 1>would start taking it taking a new dose sooner rather

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<v Speaker 1>than later. Uh and And it's alleged that Produced had

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<v Speaker 1>its sales reps misrepresent this, uh two doctors uh and

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<v Speaker 1>and so this is largely the the The interesting thing

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<v Speaker 1>is it's sort of like groundhog Day. They were led

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<v Speaker 1>guilty to essentially the same charges in two thousand and seven,

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<v Speaker 1>and we're fined a substantial amount of money, and it

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<v Speaker 1>looks like they're back at it again. And Leo produced

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<v Speaker 1>said that that it's misconduct that it pleaded guilty to

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<v Speaker 1>was only from through two thousand one, and then it

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<v Speaker 1>stopped and they regret what they did. Is there proof that, uh,

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<v Speaker 1>that you've seen or that you know of that the

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

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<v Speaker 1>I would not want to comment on whether or not

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

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<v Speaker 1>I think that you know. Another aspect of this is, uh,

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<v Speaker 1>basically the allegation that produm misrepresented the risk of misuse

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<v Speaker 1>and addiction, which was for these long release UM formulations

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<v Speaker 1>was supposed to be lower and it and it appears

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<v Speaker 1>that perhaps it wasn't lower, and these drugs were made

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<v Speaker 1>out to be safer than than they were in fact. UM.

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<v Speaker 1>But you know, certainly, UM, there may have been continued

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<v Speaker 1>uh wrongdoing on the part of some representatives who continued

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<v Speaker 1>to essentially make claims about the medication that we're not

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<v Speaker 1>we're not rooted in the evidence. Richard, What is the

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<v Speaker 1>fact that that there might be ongoing wrong doing? Tell

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<v Speaker 1>us about that earlier plea agreement? I mean usually, I

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<v Speaker 1>think plea agreements have provisions in them that try to

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<v Speaker 1>make sure that the defendant doesn't doesn't repeat the behavior. UH.

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<v Speaker 1>Can we infer can we imagine that maybe that that

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

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

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<v Speaker 1>And I think the interesting aspect of this, and I

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<v Speaker 1>don't know the answer, is how long it was supposed

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

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<v Speaker 1>was off, they may have reverted back to what they

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<v Speaker 1>were doing before. At least that seems to be what

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<v Speaker 1>the government is alleging. Leo. There are all kinds of

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<v Speaker 1>problems with the opioid crisis. There's addiction, there's treatment, there's

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<v Speaker 1>regulatory policy, enforcement, all kinds of different things. Is there

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<v Speaker 1>one area that you would cite as the most important

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<v Speaker 1>to handle immediately? And you have about forty seconds here? Sure,

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<v Speaker 1>I think, uh, you know, first, stop people from dying

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<v Speaker 1>when they order, so, making sure that people are revived

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<v Speaker 1>and receive help, and that, you know, moving upstream, making

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<v Speaker 1>sure that people have access to adequate and evidence space

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<v Speaker 1>drug treatment. Those are the two top priorities to sort

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<v Speaker 1>of bend the curve right now, Richard, Do you want

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<v Speaker 1>to mention your top priority in your mind? Well, I'm

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<v Speaker 1>not sure what that would be, but I would say

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<v Speaker 1>that the litigation, the civil litigation that you spoke of earlier,

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<v Speaker 1>is probably not going to be uh much of a

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<v Speaker 1>much of a solution. It might enrich state governments, but

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<v Speaker 1>I don't know if it's going to do very much

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<v Speaker 1>to alleviate the obioid crisis. Thank you both for being

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

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<v Speaker 1>University of Kentucky School of Law, and Leo Biletsky, professor

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<v Speaker 1>at Northeastern University Law School, coming up on Bloomberg Law.

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<v Speaker 1>A federal judge has rejected a request from eighteen states

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<v Speaker 1>and d C to force the Trump administration to resume

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<v Speaker 1>paying Obamacare subsidies, so called cost sharing reduction payments to

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<v Speaker 1>health insurers. This is Bloomberg