Governor Hogan’s decision to sign an executive order to declare Maryland’s heroin crisis as a state of emergency follows the drug related deaths of 2,600 Marylanders; the hope is that more deaths will be prevented through additional funding to combat the spread of opioids. This is no simple feat; Baltimore has been dubbed the heroin capital of the United States: one in ten Baltimore residents is addicted to the drug, according to the U.S. Drug Enforcement Agency. In a city of 645,000, the city’s Department of Health places the number of heroine addicts at 60,000. Tom Carr, the director of the Washington/ Baltimore High Intensity Drug Trafficking Area program, describes Baltimore as a “heroin town.”
“There is an appetite for heroin in Baltimore,” Carr said.
Where did this addiction come from? Why is Baltimore City such a popular city for this form of addiction? And what is being done to combat the issue?
In the early 1990s, pharmaceutical companies assured the medical community that prescription opioid pain relievers were not addictive; in turn, healthcare providers began prescribing these medications at increased rates. Eventually, the drugs were misused, and more potent options became available – heroin included.
The issue of drug addiction is too often minimized to the “bad habits” of the poor; little do we hear about the role of the federal government in fueling this crisis. Joe Rannazzisi, a former DEA employee, revealed that the opioid crisis was spread in part by Congress, lobbyists, and the drug distribution industry. Rannazzisi asserts that companies like Purdue and Johnson & Johnson were aware of the illegal usage of these drugs, but refused to address mass addiction, in order to continue raking in profit. Rannazzisi also claims that drug distributor McKesson was intentionally pumping drugs into American communities.
On a related note, Baltimore City recently declared that it will sue two drug companies – drug manufacturer Purdue and distributor McKessen – over the marketing of opioids. City Solicitor Andre Davis claims that these companies, in addition to local businesses, were aware of the pills’ potential to destroy lives. The damages won in the lawsuit, if any, will be allocated towards alleviating rising police and health care costs associated with the epidemic.
However, given the history of these companies, Baltimore should prepare itself to lose millions of dollars in litigation fees for a case that will ultimately end in the favor of Purdue and McKessen. When McKessen was hit with a $13.2 million fine in 2008, the company, along with Cardinal Health, filed a complaint to Congress: the distributors refused to continue working with the DEA if the former were to continue being treated as “foreign drug cartels.”
After numerous complaints were filed, Rannazzisi was called into a meeting at the Justice Department, which questioned his hardline on the drug companies’ actions. DEA attorney Jonathan Novak eventually noted that the DEA’s approvals of prosecutions became more difficult – the agency was easing up on Big Pharma, and active cases became more difficult to investigate due to roadblocks imposed by DEA superiors. Another pattern was noted: DEA lawyers would begin working for the drug industry and lobbied their former employers to drop multiple cases. The biggest move, however, by the drug industry, was the 2014 introduction of the Controlled Substances Act, which Novak says strips the DEA of its ability to freeze shipments of prescription narcotics to keep the drugs from entering American communities.
Furthermore, last August, Attorney General Sessions announced the formation of the Opioid Fraud and Abuse Detection Unit as a program of the Department of Justice. While the program focuses on identifying and prosecuting individuals who are contributing to the epidemic, it does not address the debilitating effects of drug usage that the drug industry has allowed to occur in American communities.
As long as the relationship between federal and state governments and the drug industry persists, Americans will continue to suffer the consequences of mass addiction. And while cities like Baltimore have decided to tackle the issue through litigation, the influence of Big Pharma will continue to transcend American healthcare and contribute to the one of the greatest public health threats in the history of the United States.
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