Shame and blame in a lame nomination for drug policy chief

marino-300x169Some powerful political players deserve a big dose of public condemnation for bungling and stalling the nation’s desperately needed war on the epidemic abuse of opioid drugs.

President Trump  can step up for the first of a series of smacks for nominating yet another dubious candidate for one of the nation’s high offices—in this case the “drug czar,” who plays a critical role in the campaign to curb the tens of thousands of deaths now blamed on opioids’ abuse.

Trump had put up for the position Tom Marino, a Pennsylvania Republican congressman (photo above). The president spoke with enthusiasm on his behalf. He did so even after CBS TV’s “60 Minutes” and the Washington Post put out their joint investigation of Marino, showing how the congressman had acted as a Big Pharma tool. Marino arm-twisted the federal Drug Enforcement Agency and congressional colleagues to get a law passed that gutted regulators’ authority to prevent Big Pharma’s wholesale distributors from flooding parts of the country with tens of millions of opioid doses, drugs that caused untold addictions and deaths.

The congressman and his allies, while taking millions in Big Pharma campaign contributions, had undercut the DEA for years, 60 Minutes and the Washington Post found. The news organizations said Marino wore down his opposition, especially so the DEA stopped battling with him. Then, using a parliamentary tactic—a call for “unanimous consent,” a snap vote in which individual members’ decisions don’t get recorded—he sneaked his dubious law through Congress and to its signing by President Obama.

The congressman, a onetime federal prosecutor, defended his measure, insisting it would protect small, innocent drug stores and patients with legitimate painkiller needs from abrupt, unwarranted cut-offs of their supplies. Trump defended Marino, calling him a “fine man,” and deflecting questions how his staff had failed to suitably investigate yet another presidential nominee or what he would do about him.

Marino eventually withdrew from consideration.

Still, the president’s cluelessness not only raises concern about his Administration’s capacity to govern, it also makes his hyperbole and bluster painful to the extreme. Consider: Even as he and his aides were under fire for the Marino nomination, Trump, trying separately to make public peace with Senate Majority Leader Mitch McConnell, joked about how much money Big Pharma pours into U.S. politics.

The industry forks over “massive amounts of money to political people,” Trump said at an impromptu news conference, turning to McConnell, who was standing to his side. “I don’t know, Mitch, maybe even to you.” McConnell let out a short laugh.

But, as the online health news service Stat has pointed out, this is no joke. McConnell, one of the powerhouses in Washington lawmaking, has taken hundreds of thousands of dollars in Big Pharma cash in his recent races. Republicans ($15.5 million) lead Democrats ($12.45 million) in taking this industry lucre. And while the wealthy chief executive claims that he can’t be swayed by such contributions, Big Pharma has poured hundreds of thousands into his election and his inaugural.

In the boondoggle over DEA enforcement powers, of course, there no blame to be spared for Democrats as well as Republicans. Sen. Claire McCaskill, a Missouri Democrat, has both called for legislation to roll back Marino’s bill and, grudgingly, admitted that she and others in Washington—up to and including President Obama and his Administration— failed in their due diligence about the awful law.

But Judy Chu, a Southern California congresswoman and one of the few Democrats to co-sponsor Marino’s bill, argues a slightly different twist on this debacle. Joined now by 30 senators, she has asked for a congressional investigation, contending that Chuck Rosenberg, the previous DEA chief, misled her and other lawmakers about this bill and how it would gut efforts to crack down on drug distributors. Chu said she demanded that Rosenberg detail and defend the measure, as he did, after she read negative reports about it in the Los Angeles Times in 2016.

That brings up another curious sidelight to the Marino controversy: Much of the odious conduct by he and his allies had been reported by the West Coast newspaper last July as part of its deep dig into “how Purdue Pharma, which has reaped more than $31 billion from the painkiller OxyContin, collected extensive evidence suggesting illegal trafficking of its drug and, in many cases, did not share the information with law enforcement or cut off the flow of pills.”

Some of the news organization’s reporting focused on illicit acts that occurred in Chu’s district. (The paper deserves kudos for that work, and credit also must given to the Charleston, W. Va., newspaper for its investigations on opioids).  And back then, the Los Angeles Times reported salient details as to how aggressively Marino had acted with DEA, with one closed-door meeting growing so unruly that he threatened to get the Justice Department involved, arguing officials may have tried to “intimidate” a member of Congress.

But, of course, bellowing at and bullying bureaucrats is déclassé for the sophisticates of Big Pharma and its allies. As Max Kennerly, a Philadelphia plaintiff’s lawyer, details in a recent post on his blog, American politics not only is awash in drug money—its makers and their pals also are pointing this big, loaded weapon at the civil justice system, too, as “part of the war that the drug companies are fighting to keep bringing in massive profits from the opioid epidemic that they created.”

By filing “friend of the court” briefs in all manner of cases in jurisdictions high and low across the country, Big Pharma, for example, has sought to undercut campaigns by Ohio and other states to find justice via civil suits for their addicted and injured citizens, on whom governments—that’s we taxpayers—are spending billions of dollars, he says.

He points out that there’s another huge black hat in the nefarious civil system filings: the U.S. Chamber of Commerce. The business group coyly claims to be protecting entrepreneurial interests while “narrowing the law to make it impossible to sue drug manufacturers even when they have clearly broken federal law. But in the past few years they’ve ramped up matters considerably, and now they seem particularly keen on thwarting arguments that could be used against the opioid manufacturers.”

In my practice, I see not only the huge harms that patients suffer while seeking medical services but also the wreckage inflicted on them and their lives by dangerous drugs, as well as their giant struggles to afford medications and their skyrocketing prices. It is revolting to see how Big Pharma’s corruptive tactics have taken such deep, pervasive root, and, at the same time, to see their bitter toll rising by the day.

Americans need to inundate their elected officials’ offices with calls, emails, and letters to let them know they’re sick to death of the bloviation, bureaucracy, and slow-walk of concrete ways to curtail not only opioid drugs’ harms but also of sky-high medication costs, a leading contributor to the ever-rising prices of medical services overall.

Nicholas Kristoff, a New York Times Op-Ed columnist, has caught, I think, the outrage we all should feel, writing that America’s drug wars have been an abject failure because, “we ignored the biggest drug pushers of all: American pharmaceutical companies. Our policy was: You get 15 people hooked on opioids, and you’re a thug who deserves to rot in hell; you get 150,000 people hooked, and you’re a marketing genius who deserves a huge bonus.”

He condemns Big Pharma for having “systematically manipulated the entire country for 25 years,” while “its executives are responsible for many of the 64,000 deaths of Americans last year from drugs — more than the number of Americans who died in the Vietnam and Iraq wars combined.”

He says the drug industry and all its various aspects, abetted by other greedy interests, are little more than “drug dealers in lab coats,” and he finds it “maddening that the public narrative is still often about an opioid crisis fueled by the personal weakness and irresponsibility of users. No, it’s fueled primarily by the greed and irresponsibility of drug lords — including the kind who inhabit executive suites.”

His column’s conclusion also is worth repeating:

I was invited the other day to a gala honoring the CEO of one of these pharma companies for his moral leadership. I wanted to throw up. Since 2000, more than 200,000 Americans have died from overdoses of prescription opioids — the consequence of a deliberate strategy to make money by ignoring public welfare. Our pattern of opioid addiction points to a tragedy, driven by the greed of some of America’s leading companies and business executives, systematically manipulating doctors and patients and killing people on a scale that terrorists could never dream of. There’s a lot of talk in the Trump Administration about lifting regulations to free up the dynamism of corporations. Really? You want to see the consequences of unfettered pharma? Go visit a cemetery.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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