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Sat Jul 20, 2019, 08:11 AM

Ex-pharma chief charged with flooding Appalachian towns with opioids

Source: The Guardian

Federal prosecutors have charged a former president of a major pharmaceutical distributor with flooding parts of Appalachia with millions of opioid pills while ignoring evidence they were driving addiction and death. The arrest of Anthony Rattini, the ex-head of Miami-Luken, on criminal charges marks a significant shift in legal action to hold the drug industry to account for the US opioid epidemic as hundreds of civil actions against manufacturers and distributors head to court.

Rattini is accused of distributing powerful narcotic painkillers for other than medical reasons to more than 200 pharmacies across West Virginia, Ohio, Indiana and Tennessee.
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The company has previously acknowledged delivering 5.7m opioid pills between 2005 and 2011 to the small town of Kermit, West Virginia, with a population of just 380 people. In 2008 alone, it shipped 5,264 pills for every man, woman and child in Kermit.

Miami-Luken went out of business in January as federal prosecutors closed in. Its former chair, Joseph Mastandrea, was alone among drug distributor executives who appeared before Congress in 2018 in conceding that his firm had played a role in the spread of an epidemic estimated to have claimed more than 400,000 lives over the past two decades.

Read more: https://www.theguardian.com/us-news/2019/jul/19/opioids-crisis-appalachia-painkillers-drugs



Although the wheels of justice turn slow, this is great news toward removing this evil plague from our society.

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Reply Ex-pharma chief charged with flooding Appalachian towns with opioids (Original post)
KY_EnviroGuy Jul 20 OP
Scarsdale Jul 20 #1
True Blue American Jul 20 #5
demtenjeep Jul 21 #30
True Blue American Jul 21 #32
madaboutharry Jul 20 #2
True Blue American Jul 20 #3
KY_EnviroGuy Jul 20 #7
ck4829 Jul 21 #25
ck4829 Jul 21 #24
Blues Heron Jul 20 #4
True Blue American Jul 20 #6
KY_EnviroGuy Jul 20 #8
True Blue American Jul 20 #11
True Blue American Jul 20 #12
BigmanPigman Jul 20 #15
demtenjeep Jul 21 #31
KY_EnviroGuy Jul 22 #37
ck4829 Jul 21 #23
duforsure Jul 20 #9
ck4829 Jul 21 #22
hughee99 Jul 21 #35
Bayard Jul 20 #10
KY_EnviroGuy Jul 20 #13
keithbvadu2 Jul 20 #14
VarryOn Jul 20 #16
KY_EnviroGuy Jul 21 #19
Jedi Guy Jul 21 #27
KY_EnviroGuy Jul 21 #29
True Blue American Jul 21 #33
mountain grammy Jul 20 #17
KY_EnviroGuy Jul 21 #18
ck4829 Jul 21 #21
ck4829 Jul 21 #20
magicarpet Jul 21 #26
Turbineguy Jul 21 #28
KY_EnviroGuy Jul 21 #34
Turbineguy Jul 21 #36

Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 08:20 AM

1. "60 Minutes" had a segment

a few years ago about this. People were bribed to vote (guess which way?) with pills. Also many people were on disability because of crooked lawyers getting Social Security payments for them. One town had almost everyone on SSI. THIS is one reason why universal healthcare is supposedly too expensive for the USA, while other countries manage to get it for their residents. How many of those states are under gop control?

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Response to Scarsdale (Reply #1)

Sat Jul 20, 2019, 08:43 AM

5. You are 100% right

On both the facts and what needs to be done. I know quite a few too lazy to work managed to get on both SSI and Medicaid. All need to be brought under one umbrella.

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Response to True Blue American (Reply #5)

Sun Jul 21, 2019, 02:32 PM

30. and then there are those of us who continue working despite critical illnesses

that could kill us at any time

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Response to demtenjeep (Reply #30)

Sun Jul 21, 2019, 04:45 PM

32. That is what really

Gets me. I worked with many who did the same thing,work8ng with pain, trying to raise children on their own.

My sympathy and understanding go with you. Honestly I have done the same.

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 08:22 AM

2. A hierarchy of corrupt conspirators,

each one in it for the money.

There is something so wrong with some people.

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Response to madaboutharry (Reply #2)

Sat Jul 20, 2019, 08:40 AM

3. Jackson County

In Southwest Ohio is one of the hardest hit.

Sherrod Brown is now concentrating on that area to bring jobs. Close to the horrendous family murder that DeWine promised to solve until they turned the cameras off. Any fool knew it was drug related.

I wish Sherrod luck but until they send more profiteers to jail I have my doubts.

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Response to madaboutharry (Reply #2)

Sat Jul 20, 2019, 08:52 AM

7. Systemic corruption mostly in areas under economic stress.

No way in hell these people involved didn't know they were addicting and killing a lot of people.

(snips)
Most of them went to two Save-Rite pharmacies whose owner was later jailed for working with a doctor running a “pill mill”, which prescribed narcotics in large quantities to anyone prepared to pay cash and drew people from hundreds of miles away.

Federal prosecutors also charged the owner of the Tug Valley Pharmacy in nearby Williamson, Samuel Ballengee, over his orders from Miami-Luken. The company sold 6.4m pills to the small pharmacy, notorious in a town of about 3,000 people for the long lines of out of state cars at its drive-through window.

Similar events have happened in Kentucky as well.

Pure, raw greed........

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Response to KY_EnviroGuy (Reply #7)

Sun Jul 21, 2019, 10:35 AM

25. Absolutely

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Response to madaboutharry (Reply #2)

Sun Jul 21, 2019, 10:35 AM

24. Indeed

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 08:41 AM

4. wasn't it the other way around ie they were "sucking down" vast quantities

were big pharma really just sending boxes of pills "here, have this thought you guys might want this" ?

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Response to Blues Heron (Reply #4)

Sat Jul 20, 2019, 08:47 AM

6. Pill pushers

Were pushing Doctors to prescribe. Now most Doctors are prescribing less of the addictive pain killers so the rate is dropping

Put more unethical Doctors and Pharma CEO’s in jail. See how quick it slows.

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Response to True Blue American (Reply #6)

Sat Jul 20, 2019, 09:20 AM

8. Now, it's very difficult for patients who need the drugs to get them.

And that's from legit doctors that are scared to hell to prescribe. But it does not stop the corrupt doctors.

I see the problem as one of systemic corruption from top to bottom because everyone in the supply chain knows there's far more pills going into these areas than what would be used for normal medical treatment.

So it goes from crooked doctor to crooked pharmacy to crooked distributor to crooked manufacturer.

Seems that the flow of these addictive drugs should be closely monitored real-time by a government agency, looking at per capita usage for each area. Why didn't alarm bells ring somewhere before 5,264 pills could be prescribed for every man, woman and child in Kermit, WV?

Apparently, the piecemeal system that's in place has too many holes (snip):
The criminal charges came days after the release of DEA data revealed that drug distributors delivered more than 75bn opioid pills across the country between 2008 and 2012.

The charges will be of concern to executives of other distributors because they include accusations that the company ignored DEA warnings to report suspiciously high orders for opioid pills.


It appears that right now, the DOJ is playing whack-a-mole games......

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Response to KY_EnviroGuy (Reply #8)

Sat Jul 20, 2019, 10:31 AM

11. The one Pharmacy in West Virginia

Was doling out 600,000 pills a week in a very small town. Big Pharma was supplying them.

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Response to KY_EnviroGuy (Reply #8)

Sat Jul 20, 2019, 10:35 AM

12. Instead of rounding up

Illegal children they should be rounding up the illegal pill pushers. I include those hiding behind a reputable company.

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Response to KY_EnviroGuy (Reply #8)

Sat Jul 20, 2019, 08:01 PM

15. I have experienced this and so have my friends and family.

People in their 80s can't get pain pills for three crummy days after a serious surgery since they cold get addicted. Give me a break. This country always goes to extremes...all or nothing. So let people in severe pain suffer...that is sadistic!

Rachel Maddow covered this on her show last night. She did a good job. The journalists at the Wash Post have a site where you can get incredible details about the pills and which pharmacies (like Walmart) and which doctors and which drug companies specifically shipped what and how much to whom and when. W. Virginia was ground zero.

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Response to KY_EnviroGuy (Reply #8)

Sun Jul 21, 2019, 02:37 PM

31. exactly right...I have severe crohn's disease and now diabetes

I have a lot of complications because of the Crohn's. Have had pancreatitis 8 times in the last 10 years-MORE PAINFUL THAN CHILDBIRTH by far and it has left me in constant daily pain. PLUS I can't take regular aspirin or Tylenol because it could cause another round of pancreatitis. As a result I am prescribed hydrocodone and a controlled release Oxycontin daily. BUT I have to physically go to the doctor monthly to get a paper script to take to pharmacy to fill. And the doctors are very strict on when to fill.

I could not function in life without pain control

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Response to demtenjeep (Reply #31)

Mon Jul 22, 2019, 04:33 AM

37. It seems your case is a good example of the good intention of law...

and how full of holes the regulations can be for abuse. You, your doctor and your pharmacist are following the rules while another doctor and pharmacy down the street may be running pill mills. This industry needs to be totally controlled from top to bottom and not just for end-users like you.

I wish you well with dealing with your disease and glad you're at least getting some help......

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Response to True Blue American (Reply #6)

Sun Jul 21, 2019, 10:34 AM

23. Right

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 09:28 AM

9. Why aren't GOP members of Congress accountable?

Who helped push approved of these knowingly deadly and dangerous drugs because they were paid held criminally liable too?

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Response to duforsure (Reply #9)

Sun Jul 21, 2019, 10:34 AM

22. Good question

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Response to duforsure (Reply #9)

Sun Jul 21, 2019, 06:39 PM

35. The GOP in congress that pushed for FDA approval?

Drugs like oxycodone?

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 10:29 AM

10. In my small town, Kentucky

I know several people on Medicare/Medicaid, who are classified as disabled and unable to work. Back problems, or whatever. They get all these pain pills/opioids, and then sell them for big bucks. They are fine to work if they are paid in cash.

I had one that worked for me a few years ago. I mentioned that I had gotten a prescription for pain that I filled and threw in a drawer, and often didn't fill them at all anymore. He was aghast--Oh, no! get them filled! I can sell those for you.

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Response to Bayard (Reply #10)

Sat Jul 20, 2019, 11:14 AM

13. There's a number of serious problems that are ingrained in the system....

just from my meager exposure to these issues:

* most doctors nowadays will not prescribe opioids but instead prescribe max dosage Tylenol until one has to be sent to a pain management clinic. However, some doctors don't give a damn and freely prescribe the stuff like candy. It seems the medical profession needs a monitored ethics system that would help stop that practice, or the government needs to implement a system for monitoring all addictive drugs that covers all prescriptions.

* outside of opioids, I've seen massive oversupply of drugs sent to patients even by Expresscripts. Not sure how that happens, but some people need to get their shit together. I had one friend that was on Effexor and she had hundreds too many pills they had sent. Of course, the manufacturers don't give a damn and laugh all the way to the bank.

It seems the root problem is that there's no overall system of accountability or checks and balances, and no one cares so long as profits stay high and they don't even seem to care until hundreds of people die.

One thing we can rest assured of: this industry, like all others, cannot be relied on to self-regulate. They've proven it far too many times.

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 11:32 AM

14. Trump country? Drugs and SSI

Trump country?

Drugs and SSI

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 08:36 PM

16. I dont understand how patients find tnese doctors who over-precribe.

I live in Arkansas, and we are one of the top opiod-abusing states.

I get kidney stones every 2-3 years, and I am a migraineur. While opiods are not regularly used nor advised for migraines, they are prescribed in certain specific situations. So, bottom line, I need pain pills from time-to-time.

Forget getting them at the ER. No local one will prescribe...at least for those conditions. And my GP, urologist, and neuro give them out very sparingly. No more than a week's supply.

The FDA and state have ethical doctors afraid to precriibe pain pills, even to patients who have legit diagnoses.

You'd think there could be laws written where patients who need these drugs could be registered just like some states do on medical marijuana. Then, put steep penalties for selling your pills.

There needs to be a way to help legit patients get access to these medications. As it is, pain patients are losing out because of bad actors.

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Response to VarryOn (Reply #16)

Sun Jul 21, 2019, 09:41 AM

19. Just as with any profession - including preachers - there's always a small percentage....

that are just psychopathic and greedy enough to dive into the dark side, and will do anything to make a buck. From what I've heard through the grapevine, knowledge of these errant doctors spreads by word of mouth between existing users and potential new ones.

Considering much of this problem exist in rural areas, I suspect another factor is a likelihood that doctors in rural clinics don't make the money that big city doctors do and are more prone to be tempted to go astray.

I've said for years that when some brilliant scientist comes up with a way to accurately measure pain levels in humans, that would solve much of our 'script pain reliever abuse problem. No confirmed pain, no pills.

My leanings would be toward strict monitoring and reporting of the drug's path of existence from manufacture to user, rather than tracing users because legit users are under a legitimate doctor's care. There's no way to monitor illegitimate users and crooked doctors which represents the bulk of this problem.

KY...........

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Response to KY_EnviroGuy (Reply #19)

Sun Jul 21, 2019, 10:57 AM

27. Part of the problem is that medical science can't really "measure" pain.

It's basically just "a distressing feeling caused by intense or damaging stimuli." We know that some conditions cause certain types of pain, which are potentially useful in diagnosing the issue, but it's really hard to get an objective measure of pain.

As an example of how subjective pain can be, I carried a kidney stone around for six months because they were hoping it'd pass without requiring surgery, and I was working full-time for the entire duration. A friend of mine got a kidney stone and was, for all intents and purposes, totally out of commission for two weeks. I was taking Vicodin and able to function, though I definitely was not a happy camper. He was taking Percocet, a stronger pain med, and he was still unable to function. Same condition, very different responses to the pain it caused.

The only somewhat-objective measure of pain that I've ever heard of is fMRI (functional magnetic resonance imaging), which isn't exactly practical to use every time someone comes in and complains of pain. Apart from that, physiological responses such as blood pressure, heart rate, and the like can be an indication of whether or not someone is shamming or exaggerating, but those are also affected by pain tolerance.

The best solution to the present issue would be to find/create a medication that effectively kills pain but has no addictive component. The problem is that drug companies have no incentive to do so, because when your medications are effective and addictive, you have a golden goose. For that reason, I'm not holding my breath regarding a breakthrough pain med anytime soon.

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Response to Jedi Guy (Reply #27)

Sun Jul 21, 2019, 11:21 AM

29. Thanks and I'm glad you got my point.

I have a weird system chemistry and most any pain med lays me out mentally but do little to help with pain. The horse pill 800mg Ibuprofen like dentists pass our do about as good as any for me.

I was thinking (space age) of some sort of brain wave sensor that could be attached to a person's head or maybe even implanted to detect true pain, but I'm a dreamer, LOL.

I suspect that considering the massive lawsuits against some drug companies right now, perhaps they will refocus on designing a pain drug that is not so addictive. I think one or more companies in Europe are working in that direction now.

KY........

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Response to KY_EnviroGuy (Reply #29)

Sun Jul 21, 2019, 04:51 PM

33. That is what the Dentist gave me

When I had implants. She said that was the strongest so I could still drive. Helped some, but since I dislike drugs of any kind they helped me.

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Response to KY_EnviroGuy (Original post)

Sat Jul 20, 2019, 10:42 PM

17. Ain't capitalism great!

All about the money. That's some database.

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Response to mountain grammy (Reply #17)

Sun Jul 21, 2019, 09:18 AM

18. Yes, Grammy and it's killing us all.

Pollution, drugs, worsening access to good healthcare, falling wages and all that to increase profits.

And the Republicans are celebrating its "success"......

KY.....

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Response to mountain grammy (Reply #17)

Sun Jul 21, 2019, 10:34 AM

21. +1

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Response to KY_EnviroGuy (Original post)

Sun Jul 21, 2019, 10:33 AM

20. Sounds like quite the drug lord

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Response to KY_EnviroGuy (Original post)

Sun Jul 21, 2019, 10:45 AM

26. Isn't free market unrestrained capitalism grand ?

You can get your neighbors addicted to pain killers,... cause premature death,... and get filthy - filthy rich during the process.

AmeriKKKan Exceptionalism is just so special. It is no wonder we are the envy of the entire world. Profit absent ethical considerations.

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Response to KY_EnviroGuy (Original post)

Sun Jul 21, 2019, 11:06 AM

28. I was watching a German mystery series recently (Tatort - Borowski on Mhz).

A young woman is struggling with addition.

If she doesn't take dope she gets a meaningless minimum wage job that comes with a drab and wretched existence. Nobody loves her but she won't die from an overdose. If she takes dope, she's happy, loves everybody, and won't feel the overdose kill her.

When you have a society designed for only the top of the heap to be happy, things are bound to turn out this way.




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Response to Turbineguy (Reply #28)

Sun Jul 21, 2019, 06:26 PM

34. K&R. Sometimes it seems like a feature of our society rather than a flaw.

One could see drug and alcohol use as a means to weed out the weak so only the more psychopathic ones are left to blindly support laissez-faire capitalism.

Many people I've known who have suffered from drug or alcohol addiction were very good people at their core but couldn't stand the stress of our dog-eat-dog society.

A second positive side-effect for the wealthy is that they get to make tons of money off their privatized prison and healthcare systems.

KY......

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Response to KY_EnviroGuy (Reply #34)

Sun Jul 21, 2019, 07:32 PM

36. Then by pretending that addition is actually "free will"

and "poor life choices" all those profits other the misery of others become morally sound.

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