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How OxyContin's maker tried to influence Trump's opioid commission

Documents obtained by VICE News reveal that a top executive at Purdue Pharma met with a member of the commission created by President Donald Trump to advise his administration on the opioid epidemic.

by Keegan Hamilton
Oct 18 2017, 1:01pm

A top executive at Purdue Pharma, manufacturer of the painkiller OxyContin, met with a member of the commission created by President Donald Trump to advise his administration on the opioid epidemic, according to documents obtained by VICE News. During the June meeting, the executive offered suggestions on how to fix a crisis the drugmaker has been widely blamed for creating.

The previously unreported meeting and a letter sent from the company to the commission were disclosed in nearly 3,000 pages of public records obtained by VICE News under the Freedom of Information Act from the Office of National Drug Control Policy (ONDCP), the White House organization that “provides administrative and financial support” for the opioid commission.

The five-page letter, sent June 29 and signed by J. David Haddox, Purdue’s vice president of health policy, lays out the company’s preferred “policy options” for addressing opioid addiction and overdoses. The letter, addressed to New Jersey Gov. Chris Christie, the commission chairman, and others sent to the commission by drugmakers reveal how Purdue and a handful of other drug companies and distributors with significant financial stakes in the opioid commission’s findings have attempted to exert their influence.

“He handed me brochures on their outreach efforts. After the discussion, I thanked him for the information and moved on to the next person waiting to speak with me.”

Haddox begins by stating that he’d recently met with commission member Bertha Madras, an addiction researcher and professor of psychobiology at Harvard Medical School, to discuss the company’s suggestions. He also notes that the president could act on Purdue’s recommendations without approval from Congress.

“Purdue supports several public policies we believe will help reduce misuse, abuse, and diversion of, addiction to, and fatal overdose from opioid analgesics,” Haddox wrote. “To supplement our conversation, I offer these policy options from Purdue, along with ideas for implementing them through executive actions.”

The Connecticut-based drugmaker’s letter (viewable in full below) lists five proposals for responding to the opioid crisis: Limiting “the duration of the first opioid prescription” for people on Medicare, expanding state prescription-drug monitoring programs, requiring doctors who prescribe opioids to demonstrate “competence,” encouraging drug companies to create “abuse-deterrent” pills, and offering enhanced training for doctors to spot addicted drug users and refer them to treatment.

Similar suggestions were included in the opioid commission’s interim report, released July 31. The report called for Trump to mandate additional “education training in opioid prescribing” and to provide federal funding to enhance prescription drug monitoring programs. The recommendations, which addiction specialists and policy experts praised, also included calls for expanded access to medically-assisted treatment, greater enforcement of rules that require insurers to cover mental health care, and a number of other proposals not mentioned by Purdue.

The documents obtained by VICE News detail more than 8,000 public comments submitted to the opioid commission, mostly from average citizens who wrote to voice concerns or offer their own ideas for solving the opioid crisis. The majority of the letters are from individuals urging Christie to consider medical marijuana as a solution to the opioid epidemic, a suggestion the commission has so far ignored.

The Office of National Drug Control Policy declined to comment on Purdue’s letter and referred questions to Christie’s office. A spokesman for Christie said the governor “has not been discussing any of the details about [the] work and deliberations of the commission” and would not be available for comment until the commission’s final report is released on Nov. 1.

Purdue also declined to answer questions. “The letter speaks for itself,” a company spokesman wrote.

READ: Ultra-potent synthetic heroin is spreading across the U.S.

Madras, the commission member who met with the Purdue rep, said in an email that the encounter was brief and informal — she’d held “office hours” at a hotel and invited members of the College on Problems of Drug Dependence to stop by and offer their input on the commission. She wrote:

“A Purdue rep signed up to speak with me. He told me that they 1. currently had 2% of USA market share for opioids and 2. had developed educational programs and outreach for safe prescribing. He handed me brochures on their outreach efforts. After the discussion, I thanked him for the information and moved on to the next person waiting to speak with me.”

Madras added that there was “no pre-screening of people who signed up” to meet with her and said she “did not anticipate the appearance of the Purdue VP.” She wrote that she decided to speak with Haddox because she had not established restrictions ahead of time about who could attend her “office hours,” and because “as a scientist, I am forever interested in learning from, and assessing all viewpoints.”

“Industries that market and profit from addictive substances — tobacco, opioids, alcohol, marijuana — traditionally attempt to minimize risk of addiction and maximize benefits of their products,” Madras wrote. She concluded that she “did not learn anything of core relevance” from Haddox to shape her input to the commission.

New Jersey Gov. Chris Christie, who is chairman of President's Commission on Combating Drug Addiction and the Opioid Crisis, accompanied by Massachusetts Gov. Charlie Baker, second from left, and N.C. Gov. Roy Cooper, right, speaks during a meeting in the Eisenhower Executive Office Building on the White House Complex, Wednesday, Sept. 27, 2017, in Washington. (AP Photo/Andrew Harnik)

Purdue’s meeting with Madras and its subsequent letter to Christie are just the latest revelations about the drug industry’s efforts to influence policymakers on opioid issues. A joint investigation by The Washington Post and “60 Minutes” published Sunday detailed how Trump’s nominee for “drug czar,” Pennsylvania Republican Rep. Tom Marino, sponsored legislation that favored the drug industry and hindered the DEA’s ability to halt large and suspicious orders for prescription painkillers. A day later, Trump announced via Twitter that Marino had withdrawn his name from consideration for the post.

READ: Trump’s opioid commission ignored 7,800 public comments about weed

Attorneys general from nearly a dozen states, including Louisiana and Washington on Oct. 2, as well as several cities and counties have sued Purdue and other painkiller manufacturers and distributors for allegedly engaging in practices that fueled the opioid epidemic. Purdue and three of its executives paid a $634.5 million fine after pleading guilty in 2007 to federal charges related to misbranding OxyContin. At the same time, campaign finance records show that Purdue, which generates about $3 billion in annual revenue, has spent more than $7.3 million lobbying federal lawmakers over the past decade, including $570,000 so far this year.

Purdue is by no means the only drug company that wrote to Christie’s commission. Others that submitted letters include the National Association of Chain Drug Stores, which represents over 100 companies that fill more than 3 billion prescriptions per year; the Healthcare Distribution Alliance, which represents wholesale drug distributors; and Walgreen’s, America’s second-largest pharmacy chain.

Another notable letter came from Adapt Pharma, the maker of Narcan, a naloxone nasal spray that reverses opioid overdoses. The company called for Christie’s commission to recommend that Trump declare a national state of emergency in response to the opioid crisis, a move that would unlock federal funding to pay for expanded access to naloxone. (Trump said he’d make the emergency declaration more than two months ago, but he has yet to follow through. He said Monday that the formal declaration would be made “next week.”)

“We suggest that the opioid commission act to protect law enforcement officers — including the DEA — by equipping them with naloxone as a protective measure against accidental overdose in the course of their duties,” Adapt Pharma wrote in its letter to Christie’s commission.

Soon after, the commission used similar language in its interim report, writing to Trump, “We urge you to mandate, with federal assistance, that naloxone be in the hands of every law enforcement officer in the United States.” The commission called for the Department of Health and Human Services to “negotiate reduced pricing” with naloxone retailers.

A carton with two doses of Narcan typically sells for $125, but police and other first responders qualify for a 40 percent discount. So if each of the nearly 1.1 million law enforcement officers in the U.S. were equipped with just one $75 carton of Narcan, Adapt would stand to gross more than $82 million.

The cost of Narcan wasn’t mentioned in Adapt’s letter, but the company noted that its reps would be “happy to meet with any members of the commission who would like more information.”



Purdue Pharma letter to the Trump opioid commission (PDF)


Purdue Pharma letter to the Trump opioid commission (Text)

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Drugs
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Opioids
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Adapt Pharma
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