WASHINGTON — President Trump spoke Monday of using federal prosecutors to pursue “major litigation” against drug manufacturers alleged to have played a role in creating a nationwide epidemic of opioid abuse.

Speaking in New Hampshire at the White House’s rollout of a national opioids strategy, the president expanded upon a Department of Justice release last month in which Attorney General Jeff Sessions pledged to “hold accountable those whose illegality has cost us billions of taxpayer dollars.”

“Our Department of Justice is looking very seriously into bringing major litigation against some of these drug companies,” Trump said. “We will bring it at a federal level. Some states are already bringing it, but we are thinking about bringing it at a very high federal level, and we will do a job.”

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DOJ filed a statement of interest on March 1 in a federal court in Ohio, asking the judge collectively overseeing hundreds of opioid-related lawsuits to allow federal lawyers 30 days to decide whether the United States would participate in the legal proceedings.

Manufacturers, including Purdue, Endo Pharmaceuticals, Insys, Janssen, and Teva, have faced scrutiny and often aggressive legal action from state and local governments seeking compensation for what many plaintiffs allege are the costs resulting from the companies’ disingenuous marketing tactics. In 2006, Purdue and several high-ranking executives paid a collective $635 million in fines pertaining to the marketing of its opioid painkiller, OxyContin, which understated the drug’s addictiveness.

Sessions’ threat to add DOJ resources to existing legal actions against manufacturers and distributors comes after a year of enforcement-side actions from the Trump administration, including crackdowns on fentanyl importation and an increased focus on opioid dealer and distribution networks across the country and overseas.

The president also name-checked two drug companies that manufacture various forms of the overdose-reversal drug naloxone: Adapt Pharma, which makes the nasally administered Narcan, and Kaleo, which makes Evzio, an automatic injector that has drawn scrutiny for its price tag but drew congratulations from Trump for having distributed more than 300,000 units for free.

After inviting Mike Kelly, the president of Adapt’s U.S. operations, to join him on stage, Trump announced the company’s plan to provide four Narcan kits to each college campus in the U.S. and two to each high school.

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  • I would add that a physician’s undertreatment or termination of opioid therapy may be unethical under the AMA Principles of Ethics
    Section VIII reads: “A physician shall, while caring for a patient, regard responsibility to the patient as paramount.”
    Sec. I reads: “A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.”
    The Code of Medical Ethics provides in part:
    “The relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest.”
    I understand a clinician’s fear of criminal investigation or regulatory discipline based on the the opioids prescribed to a given patient. But whether that fear is or is not realistic, how can s/he square protecting her own interests by undertreating, terminating or refusing opioid therapy, without violating the physician’s duty to “place patients’ welfare above the physician’s own self-interest or obligations to others?”
    Code of Medical Ethics Opinion 1.1.1
    “The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering. The relationship between a patient and a physician is based on trust, which gives rise to physicians’ ethical responsibility to place patients’ welfare above the physician’s own self-interest or obligations to others, to use sound medical judgment on patients’ behalf, and to advocate for their patients’ welfare.”

    Code of Medicial Ethics Opinion 1.1.3(e), pertaining to patients rights, states that:
    . . . .
    (i) To continuity of care. Patients should be able to expect that their physician will cooperate in coordinating medically indicated care with other health care professionals, and that the physician will not discontinue treating them when further treatment is medically indicated without giving them sufficient notice and reasonable assistance in making alternative arrangements for care.
    This duty is unequivocal and would seem to preclude doctors from terminating service and leaving in the lurch to defend for themselves chronic pain patients who test positive on a UA for an illicit substance.

  • I am a intractable pain patient and advocate who suffers with multiple incurable pain disorders for many years now. To place blame on pharmaceutical companies, physicians and pain patients is not only wrong, but irresponsible and very disgraceful.

    The real problem lies with the illicit fentynal and heroin which is being shipped into the United States. It is the main cause of over dose and deaths in the US as far as drugs are concerned. Whereas medical harm is the 3rd leading cause of death in the United States! Why are you not talking about this? Or alcohol deaths?
    It is easier to blame someone else than take responsibility of the real problem which is illicit drugs, and admit you have have no control over this situation.
    Prescription opioids have been on a steady decline since 2015, yet over dose deaths have skyrocketed. So tell me how is this the drug manufacturers fault?
    Placing more restrictions on prescription opioids have only caused more hard to legitiment intractible pain patients. Those who suffer with horrific pain are even worse now due to propaganda such as this. Get your head out of the sand, stop blaming others for this problem and get control over the illicit DRUG PROBLEM WHICH IS HEROIN AND FENTANYL!!

    STOP HURTING LEGITIMATE CHRONIC PAIN PATIENTS WHO DEPEND ON THESE MEDICATIONS TO SURVIVE!
    WE ARE NOT ADDICTS OR DRUG SEEKERS! WE ARE IN PAIN AND DESERVE TO HAVE A CHANCE AT A DECENT LIFE TOO!

    • Above is Exacy as I have posted as an MD w Professorshp status before Retired …
      Due to chronic Pain

    • I agree . . . No one but the patient knows what his pain is like! Quit shortchanging us out of fear for physicians’ licenses!

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