Opioid Epidemic
Maura Healey Expands Opioid Manufacturer Investigation
She and 38 other attorneys general are looking into their sales and marketing tactics.
The investigation builds upon work that was first announced in June and involves a bipartisan group of attorneys general across the country. Using a variety of investigative tools, the group of 39 attorneys general seeks to determine whether manufacturers Purdue Pharma, Endo, Janssen, Teva, and Allergan drove profits by misrepresenting or withholding information about the habit-forming properties and potentially dangerous consequences of their drugs. On the distribution side, they’ll examine tracking and reporting practices at AmerisourceBergen, Cardinal Health, and McKesson.
“We deserve to hear from these drug-makers what they knew about the addictive and deadly nature of opioid painkillers, and whether they misrepresented those risks in order to increase corporate profits,” Healey says in a statement. “We are expanding our investigation into opioid manufacturers and distributors to help uncover the roots of this deadly epidemic and protect American families and communities ravaged by this public health crisis.”
Initial investigations focused solely on Purdue Pharma, the manufacturer of blockbuster painkiller OxyContin and the subject of a chilling and wide-ranging 2016 exposé by the Los Angeles Times. As Tuesday’s announcement makes clear, however, Healey and her fellow attorneys general have significantly broadened the scope of their probe.
It’s easy to see why Healey, who is spearheading several parts of the investigation, wants answers from drug companies. The opioid crisis has hit Massachusetts harder than many states, accounting for thousands of deaths in the last few years alone. In response, Healey’s office has helped to launch prevention programs in Boston public schools, crack down on heroin and fentanyl trafficking, and supply Massachusetts cities and towns with the overdose-reversing drug Narcan.
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Opioid Epidemic Linked to Medicaid Expansion
An article in Wednesday’s Wall Street Journal (behind a pay wall) shows evidence that the expansion of Medicaid under the Affordable Care Act (ACA) is driving, at least in part, the opioid epidemic that is ravaging the nation.
Under the ACA, states were encouraged, but not required, to expand Medicaid access to people with higher income levels in exchange for increased federal funding. Twenty-nine states took the deal; the rest did not. According to the Department of Health & Human Services, “overdose deaths per million residents rose twice as fast in the 29 Medicaid expansion states – those that increased eligibility to 138% of poverty from 100% of the poverty line –… between 2013 and 2015.” Vermont is, of course, one of the 29, and arguably the most enthusiastic.
This trend was geographically consistent as well. For example, deaths increased twice as much in New Hampshire, and expansion state, than they did in neighboring Maine, a non-expansion state.
Similar comparisons exist between Virginia and Maryland and Ohio and Wisconsin.
Medicaid allows patients to obtain opiates at a very low cost (the article cites the example of 240 oxycodone pills for a $1 copay), which they can then turn around and sell for thousands of dollars on the street. A study by Express Scripts indicates that 25% of Medicaid recipients are prescribed opiates. Today, roughly one third of all Vermonters is now on some form of Medicaid.
Vermont got a head start on the rest of the nation, expanding Medicaid eligibility in October 2007 under the Catamount Health Plan. By 2014, then Governor Shumlin deemed it necessary to devote his entire state of the state speech to the crisis, and Politico labeled Vermont “America’s Heroin Capital.” Then we promptly expanded Medicaid again under the ACA.
Sen. Ron Johnson (R-Wisconsin) is quoted in the Journal article, “It appears that the program has created a perverse incentive for people to use opioids, sell them for large profits, and stay hooked.”
Turns out our state’s addiction to federal tax dollars is fueling our citizens’ addiction to deadly drugs.
Back in June, Governor Scott sent out a press release stating, “Governor Scott remains concerned over the harmful impact this legislation [the bill to Repeal & Replace the ACA] could have on Vermonters, including provisions in the bill relating to the Medicaid expansion under the Affordable Care Act (ACA).” In light of this new information, perhaps now the administration and the legislature should consider the harm the Medicaid expansion has caused to our state.
- Rob Roper is president of the Ethan Allen Institute
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"No-Call, No-Show" Employees: Opioid Addiction Is Devastating American Manufacturers
by Tyler Durden
Sep 20, 2017 9:15 PM
We've spent a lot of time of late discussing the impact of opioids on
the American workforce. While it is unclear exactly how much of an
impact opioids are having on the steadily declining labor force
participation rate, one thing is clear: nearly half of working age men not in the labor force today take some form of opioids on a daily basis.
But, as Bloomberg points out today, drug abuse among those still gainfully employed is perhaps an even bigger problem for American manufacturing employers because of the safety concerns it presents. Meanwhile, the additional drug testing costs associated with maintaining a safe work environment, in an era in which opioid addiction is spiraling out of control, tend to "mount up" as additional employees are required just to manage rigorous testing programs.
But, as Bloomberg points out today, drug abuse among those still gainfully employed is perhaps an even bigger problem for American manufacturing employers because of the safety concerns it presents. Meanwhile, the additional drug testing costs associated with maintaining a safe work environment, in an era in which opioid addiction is spiraling out of control, tend to "mount up" as additional employees are required just to manage rigorous testing programs.
Of course, other manufacturing companies have decided to take the opposite approach on drug testing as too rigorous a program would inevitably just result in excessive layoffs in an already tight labor market.At Philip Tulkoff’s food-processing plant in Baltimore, machines grind tough horseradish roots into puree. “If you put your arm in the wrong place,” the owner says, “and you’re not paying attention, it’s going to pull you in.” It’s not a good place to be intoxicated.Drug abuse in the workforce is a growing challenge for American business. While economists have paid more attention to the opioid epidemic’s role in keeping people out of work, about two-thirds of those who report misusing pain-relievers are on the payroll. In the factory or office, such employees can be a drag on productivity, one of the U.S. economy’s sore spots. In the worst case, they can endanger themselves and their colleagues.That’s why Tulkoff practices zero-tolerance. One randomly chosen employee gets tested every month, “and we’re gonna move it to two.” The costs mount up: He has to hire a third-party company to select the worker, and pay the clinic to conduct tests. Money is wasted training workers who subsequently drop out when they fail the screening."We caught someone recently, saw him injecting,’’ said Jay Steinmetz, chief executive of Barcoding Inc. The Baltimore company creates software, and provides equipment, that helps businesses manage their inventory. It’s a desk environment, with none of the grinding machinery that poses risks for Tulkoff’s staff.
It’s no wonder that not every boss is as rigorous as Tulkoff. “I know people who’ve said, ‘I can’t do it, I would lose too many people’,” he says.At the moment, 57 percent of employers say they perform drug tests, according to the National Safety Council. Out of those, more than 40 percent don’t screen for synthetic opioids like oxycodone -- among the most widely abused narcotics, and one of the substances that new federal rules are targeting.“I have heard manufacturers over the years say, ’We wish we didn’t have to test for drugs,’ because they lose money when they can’t fill those positions,’’ he said.
One Ohio factory owner shared her story with WTVR saying that although she has numerous blue-collar jobs available at her company, she struggles to fill positions because so many candidates fail drug tests. Regina Mitchell, co-owner of Warren Fabricating & Machining in Hubbard, Ohio, told The New York Times that four out of 10 applicants otherwise qualified to be welders, machinists and crane operators will fail a routine drug test. While not quite as bad as the adverse hit rate hinted at by the Beige Book, this is a stunning number, and one which indicates of major structural changes to the US labor force where addiction and drugs are keeping millions out of gainful (or any, for that matter) employment.And there’s no guarantee that new hires will stick around. Drug problems are accelerating the turnover among staff.“In the last three weeks, we’ve had six people come, get trained, and then are no-call, no-shows,’’ Greenblatt said. He said the biggest loss comes from taking high-performing employees out of the production process so they can train new hires. “That person is diverted into the completely unproductive task of teaching someone who’s going to leave in a day or two.’’Productivity growth in the U.S. economy has been slowing for decades. There’s little consensus about the causes. But there are signs that the spread of drug-abuse could be contributing to the problem.
Speaking to CNN’s Michael Smerconish, Mitchell said that her requirements for prospective workers were simple: “I need employees who are engaged in their work while here, of sound mind and doing the best possible job that they can, keeping their fellow co-workers safe at all times,” she said.
This has proven to be a problem.
“We have a 150-ton crane in our machine shop. And we’re moving 300,000 pounds of steel around in that building on a regular basis. So I cannot take the chance to have anyone impaired running that crane, or working 40 feet in the air.”
While President Trump addressed his blue-collar base in Ohio this week, returning to his campaign theme of getting local communities back to work and returning jobs to America from overseas, the problem may not be a scarcity of jobs: it is workers who are not under the influence. As Mitchell said she has jobs... she just doesn’t have sober applicants. For 48 of the 50 years her company has been around, drug abuse had never been an issue, she told Smerconish.
“It hasn’t been until the last two years that we needed to have a policy, a corporate policy in place, that protects us from employees coming into work impaired,” she said.
Maybe instead of focusing how to perpetuate the US waiter and bartender job recovery, the BLS - and the administration - should contemplate how to eliminate the pervasive addiction problem which is rapidly becoming a structural hurdle for America's millions of unemployed.
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