SEATTLE — Attorney General Bob Ferguson today filed a lawsuit accusing OxyContin maker Purdue Pharma of fueling the opioid epidemic in Washington state, embarking on a massive deceptive marketing campaign and convincing doctors and the public that their drugs are effective for treating chronic pain and have a low risk of addiction, contrary to overwhelming evidence. This deceptive marketing resulted in the deaths of Washingtonians and devastation to Washington families.
The lawsuit contends Purdue conducted an uncontrolled experiment on the American public without any reliable clinical evidence that opioids are effective at treating chronic pain. To doctors and patients, Purdue consistently downplayed the risks of addiction from long-term use and deceptively represented opioids as safe for treating long-term chronic pain.
Purdue’s deception yielded the company billions of dollars in profit nationwide from its opioid drugs. Ferguson’s lawsuit seeks to force Purdue to forfeit the Washington portion of those profits.
The City of Seattle filed a separate lawsuit today against Purdue, in addition to Teva Pharmaceuticals, Janssen Pharmaceuticals, Endo Pharmaceuticals and Allergan. The city and Ferguson announced their lawsuits together.
Both suits, filed today in King County Superior Court contend that Purdue’s illegal conduct contributed to excessive prescriptions and addiction, causing many addicted patients to look for other ways — including illegal means — to get more pills or to get heroin. A 2014 study found that nearly 80 percent of heroin users reported using prescription opioids prior to heroin.
By filing the state’s lawsuit, Ferguson has ended his participation in a multistate coalition investigating opioid manufacturers nationwide. Several states that have filed similar lawsuits are using outside attorneys to handle their cases. Washington is only the second state to handle its case internally.
“Purdue Pharma ignored the devastating consequences of its opioids and profited from its massive deception,” Ferguson said. “It’s time they are held accountable and pay for the devastation they caused.”
“I stand together with Attorney General Ferguson in fighting for justice for patients who were prescribed opioids and became addicted, because they were not irresponsible; they were deceived,” Seattle City Attorney Pete Holmes said. “Addiction to opioids and heroin does not stop at Seattle’s city limits. This is the city’s problem, the state’s problem, and everyone’s problem.”
“Most of our health care professionals want to do the right thing for patients, but some corporations sought to boost their bottom line to peddle opioids on false promises, which, in great part, created this crisis. These corporations must be held accountable. I appreciate the Attorney General taking this important step today,” Gov. Jay Inslee said. “This will help with some recompense so we can implement our state’s opioid response plan and my executive order with the goals to prevent the next generation from becoming addicted, to prevent overdoses and to treat people who have opioid use disorder, a true medical condition with an effective medical treatment."
Purdue falsely claims that opioids improve long-term function, have a low addiction risk that can be managed or prevented and that increased doses of opioids do not pose significant additional risks to patients.
False claims of the safety, effectiveness of long-term use
Purdue aggressively marketed its opioids for chronic pain from conditions like headaches and low back pain, despite a lack of clinical evidence that they are effective and safe for long-term use. Despite Purdue’s efforts over more than two decades, the Centers for Disease Control & Prevention (CDC) noted in its 2016 guidelines that “there is no good evidence that opioids improve pain or function with long-term use.”
Other, safer options — like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen — are effective and carry fewer risks, the CDC added.
False claims of low addiction risk and “pseudoaddiction”
Among its marketing claims, Purdue distributed thousands of videos and pamphlets claiming that opioid addiction occurred in less than 1 percent of patients. The number was not based on a clinical study, but rather a 1980 letter to the editor in the New England Journal of Medicine. The actual addiction rate is as high as 26 percent, according to the CDC.
A study sponsored by Purdue asserted that “opioids were well tolerated with only rare incidence of addiction,” and the need for higher and higher doses as patients built up a tolerance to opioids “was not a clinically significant problem when managing patients with opioids long-term.”
When signs of addiction appeared in patients, Purdue persuaded doctors that what appeared to be addiction was actually under-treatment of their pain, and to respond by increasing opioid dosages.
In marketing materials, Purdue told doctors and policymakers that “pain-relief seeking behavior can often be mistaken for drug-seeking behavior.”
The concept, called “pseudoaddiction,” was coined by Dr. J. David Haddox, who later became a Purdue executive. His theory was based on the case of a single cancer patient. No study has validated the theory of “pseudoaddiction.”
Despite a lack of evidence of “pseudoaddiction,” Purdue pushed this theory to convince doctors to give more drugs to patients who displayed signs of addiction, such as asking for early refills on their prescriptions or “doctor shopping” for additional prescriptions.
False claims on risks of overdoses
Opioids are most dangerous when taken long-term and when taken in high doses. In 2013, the FDA noted that research shows that risk of misuse and abuse is great for extended release long acting opioids and observed that these drugs are often used chronically.
Accordingly, the CDC recommends that physicians carefully reassess increasing opioid doses beyond 50 morphine milligram equivalents (MMEs), and avoid exceeding 90 MMEs per day.
Overdose risk for opioids begins at very low doses and doubles when the daily dose is between 20 MMEs and 49 MMEs. By 100 MMEs, the risk of death increases by nine fold. Overall, 1 in every 550 patients started on opioid therapy died of opioid-related causes a median of 2.6 years after their first opioid prescription. That number increased to 1 in 32 for patients receiving 200 MMEs per day.
Purdue’s sales representatives were trained to reassure prescribers that there is “no ceiling” on the amount of OxyContin a patient could be prescribed.
Ignoring red flags
Purdue sales staff kept detailed records of prescriptions in Washington by prescriber, drug strength, quantity and other factors. Purdue then used that data to aggressively market its drugs to the highest prescribers in the state.
Washington state medical boards sanctioned some of these prescribers for failing to follow rules related to opioid prescriptions and putting patients at risk. The lawsuit alleges that, in several cases, Purdue salespeople ignored red flags and continued to target these providers with sales pitches.
Details of specific interactions between Washington state providers and Purdue representatives are redacted from the complaint because Purdue contends the information is competitively sensitive. Ferguson plans to file a motion to unseal this information to reveal to the public additional details about these interactions.
Violating previous court order
Purdue has faced court action before over its deceptive marketing of OxyContin.
A 2007 court order resulting from a consent judgment with Washington and 25 other states prohibited the company from making misleading statements regarding abuse, addiction or dependence in its marketing materials for OxyContin. Purdue also promised to create an Abuse and Diversion Detection Program to detect and take appropriate steps upon detecting “atypical” prescribing patterns — including reporting “pill mill” doctors to the authorities.
Despite the court order, Purdue has continued to engage in deceptive marketing and has remained silent about suspicious prescribers it should have reported.
Washington’s epidemic
Prescriptions and sales of opioids in Washington skyrocketed more than 500 percent between 1997 and 2011. In 2011, at the peak of overall sales in Washington, more than 112 million daily doses of all prescription opioids were dispensed in the state — enough for a 16-day supply for every woman, man and child in Washington. More than 18.2 million daily doses of oxycodone were distributed in Washington in 2015.
Geographic areas in Washington with higher rates of opioid prescriptions show a strong correlation with higher overdose rates.
For example, Cowlitz, Clallam, Mason and Snohomish counties had the highest opioid overdose death rates in the state, according to the state Department of Health. Those counties also had some of the highest opioid prescription rates in the state.
Between 2009 and 2014, Washington saw a 60 percent increase in opioid-related hospital stays, the fourth-highest increase in the nation, according to a June study by the Agency for Health Care Research and Quality.
In 2015, the number of overdose deaths in Washington exceeded the number of deaths from car accidents, or deaths from firearms — whether from suicide, homicide or accidental. The majority of drug overdose deaths in Washington between 2010 and 2015 — more than 6 out of 10 — involved an opioid.
Relief
Ferguson’s lawsuit seeks civil penalties and damages. Ferguson also asks the court to order Purdue to give up the profits it made in Washington as a result of its illegal conduct. Sales of Purdue opioids are worth billions every year nationwide, and Washington’s portion is expected to be in the millions.
The surrendered profits will be used to remediate the effects of Purdue’s misrepresentations of opioids, possibly funding treatment, education and more.
Assistant Attorneys General Tad Robinson O’Neill and Kate Barach are leading the case for Washington.
Earlier this year, the Attorney General’s Office hosted a summit on Washington’s opioid epidemic in partnership with the Washington State Patrol and the Washington Association of Prosecuting Attorneys.
AGRICULTURAL REPORT, FROM THE USDA
Secretary Perdue Statement on Hurricane Maria Assistance to Agricultural Producers in Puerto Rico and the U.S. Virgin IslandsPRESS RELEASE ISSUED 9/ 29/ 17 (link source)
Washington, D.C., September 29, 2017 -- Secretary of Agriculture Sonny Perdue today pledged all resources and flexibilities at USDA's disposal as Puerto Rico and the U.S. Virgin Islands recover from the devastation of recent hurricanes.
"Agriculture producers in Puerto Rico and the U.S. Virgin Islands deserve the same resources under the USDA Farm Service Agency disaster programs as farmers, ranchers, and foresters in the rest of the country. This includes compensation for livestock death and feed losses, risk coverage for specialty crops, and repair of damage to agricultural and private forest land. To this point, FEMA has been the lead agency for emergency search and rescue operations, but USDA is involved in providing food to storm victims and is ready to assess agricultural damage and assist producers when conditions on the islands allow."
Secretary Perdue Hosts U.S. Senators for 2017 Fire Briefing
PRESS RELEASE ISSUED 9/ 26/ 17 (link source)
(Washington, D.C., September 26, 2017) – U.S. Secretary of Agriculture Sonny Perdue hosted U.S. Senators Mike Crapo (R-ID), Steve Daines (R-MT), Michael Bennet (D-CO), Jeff Flake (R-AZ), Jim Risch (R-ID), and Ron Wyden (D-OR) today at the U.S. Forest Service (USFS) for a 2017 fire briefing to hear about this year’s efforts to contain wildfires out west as well as the way the USFS is funded. Currently, the agency has to borrow money from prevention programs to combat ongoing wildfires. Secretary Perdue believes Congress should treat major fires the same as other disasters and should be covered by emergency funds so prevention programs are not raided.
“This has been a tremendous fire season,” said Secretary Perdue. “As wildfire costs exceed $2 billion, I appreciate those in Congress who recognize this funding issue and are working to make a permanent fix that allows us to manage our forests preemptively. While we can’t stop these wildfires, we know we can be prepared in a much better way.
National Chicken Month – NASS Counts Chickens Before – and After – They Hatch
PRESS RELEASE ISSUED 9/ 27/ 17 (link source)
Did you know that Georgia poultry farmers produced the greatest number of chickens for meat (broilers) with 1.4 billion in 2016 followed by Alabama and Arkansas with just over 1 billion each? In all, the total value of U.S. broiler chicken production was $25.9 billion in 2016.
The poultry sector of U.S. agriculture is broad and plays an important economic role. Since September is National Chicken Month, it’s a good time to look at where they are raised and their sales value in the United States. USDA’s National Agricultural Statistics Service (NASS) keeps track of poultry destined for the dinner plate, chickens that lay eggs, the number of hatching and table eggs as well as turkeys and ducks.
Iowa chickens produced the most eggs (13.6 billion) in 2016, followed by Ohio and Pennsylvania. United States egg production totaled 101.9 billion eggs.
Moving to numbers on all chicken, turkey, duck and other poultry meat headed to plates or soup bowls around the world, according to the Poultry Slaughter 2016 Summary there were 47.4 billion pounds of chilled and frozen meat produced in 2016.
While NASS produces data throughout the year about major poultry production via the Chicken and Egg, Poultry Slaughter, Broiler Hatchery, Hatchery Production and Egg Products reports, every five years we get a sense of how many farms of all sizes have poultry or eggs. For example, according to the 2012 Census of Agriculture, the most recent, there were 174,211 U.S. farms with 1-49 laying hens. Texas had the most farms in this category with 18,058. On the other end of the spectrum at the same time, 387 farms had 100,000 or more layers.
The agriculture census is the only time we account for birds such as pheasants, quail, chukars, peacocks, ostrich and other unique species. The next census will be collected beginning later this year. Meanwhile, check out NASS, your go-to source for poultry data to learn more about production in your area.
Cracking the Peanut Allergy - USDA Program Provides Doctors a Way to Help Children
PRESS RELEASE ISSUED 9/ 27/ 17 (link source)
Doctors and scientists have discovered a way to reduce the chances of children developing a common and sometimes deadly allergy. Recent studies have found that peanut allergies can be prevented in a high percentage of cases by introducing children to peanut-containing foods while they are still infants.
The revelation was made possible, in part, thanks to the resources provided by the National Peanut Board (NPB), an industry-funded board, established through a research, promotion and information program at the request of peanut producers. The program is overseen by the Promotion and Economics Division of USDA’s Agricultural Marketing Service, Specialty Crops Program.
With a focus on promoting U.S. grown peanuts, NPB members recognized the increased reporting of peanut allergies among American children, and realized they needed to be part of the solution. The board helped to fund a study called Learning Early About Peanut Allergy (LEAP) that was conducted by researchers at the United Kingdom’s Kings College London.
The results of the study were published in the New England Journal of Medicine . In the study, up to 86 percent of the infants with a high risk (those with severe eczema, egg allergy, or both) for developing a peanut allergy who ate peanut foods between the ages of 4 and 11 months developed a protective factor that reduced their risk of having the allergy.
To be sure that this protection was long-term and did not simply delay the start of peanut allergies, the researchers conducted a follow-on study. The second study was called LEAP-On. During LEAP-On, the children from the LEAP study who were exposed to peanut foods at an early age were not given peanut foods for 12 months. Researchers found that the protection was indeed long-lasting.
In 2008, NPB provided funding to help initiate the early research published in the Journal of Allergy and Clinical Immunology that led to the groundbreaking LEAP study and NPB continues to support this work. This research has contributed to the American Academy of Pediatrics recommending early introduction of peanut protein for infants who are at increased risk of developing the allergy. In January, the National Institute of Allergy and Infectious Diseases released guidelines for practitioners and caregivers that details when and how to introduce peanut foods safely to prevent peanut allergies. More recently, the FDA acknowledged a qualified health claim linking early peanut introduction and reduced risk of developing peanut allergies.
The collaboration between the board and researchers at the Kings College London is a great example of how USDA research and promotion boards can make a difference for people everywhere. In fact, according to the National Institutes of Health in a news release about the new guidelines, NIAID Director Anthony S. Fauci, M.D. said “We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”
With this in mind, NPB continues to promote the new guidelines and recommendations for early introduction by educating health professionals, working with influencers, and reaching out to consumers directly.
Parents should always consult with their child’s pediatrician to determine the best course of action for treatment of allergies.
ON THE STATE LEVEL
WSDA detects salmonella in Pride & Joy raw milk products
PRESS RELEASE ISSUED 9/ 28/ 17 (link source)
OLYMPIA — The Washington State Department of Agriculture (WSDA) is advising consumers not to drink Pride & Joy Dairy organic retail raw milk because it may be contaminated with salmonella, an organism that can cause serious illness.
This public health notice was initiated after routine sampling by WSDA found salmonella in bottled organic retail raw milk collected from the Pride & Joy Dairy in Toppenish. The product has a best-by date of October 4 (OCT 4). WSDA and the company continue to investigate the source of the problem. Currently, there are no reported cases of human illnesses associated with this product.
Salmonella can cause serious and sometimes fatal infections in humans. Young children, the elderly, and those with compromised immune systems are especially at risk. Healthy persons infected with salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis. Anyone experiencing these symptoms should immediately contact a health care provider.
The company sells its products in pint, quart, half-gallon, and one-gallon plastic containers. This public health notice includes all container sizes.
LOCAL MEETINGS AGENDA HIGHLIGHTS
Clallam Commission meetings
CLALLAM COUNTY WORK SESSION AGENDA HIGHLIGHTS
1) Food and Drug Administration Voluntary Retail Standards Program Grant Application
2) Overview of ORCAA program areas and programs of interest
3) Shoreline Master Program update
See full agenda
http://clallam.granicus.com/GeneratedAgendaViewer.php?view_id=2&event_id=1074
CLALLAM COUNTY REGULAR SESSION AGENDA ITEM HIGHTS
1) Proclamation recognizing the month of October 2017 as Disability Employment Awareness Month
2) Proclamation recognizing Employers of Individuals with Developmental Disabilities.
3) Agreement with Attorney John D. Black for juvenile offender attorney services
(see full agenda)
http://clallam.granicus.com/GeneratedAgendaViewer.php?view_id=2&event_id=343
PORT OF PORT ANGELES MEETING AGENDA HIGHLIGHTS
1) Resolution No. 17-1155, Public Records Policy
It is the policy of the Port of Port Angeles to make identifiable, non-exempt public records available for inspection and copying upon a proper request made in accordance with the Public Records Act, Ch. 42.56 RCW (the “Public Records Act” or the “Act”).
The Port shall provide the public full and timely
access to such records while remaining mindful of individuals’ privacy rights and the desirability of the efficient administration of Port business.
The purpose of this procedure is to guide Port staff in providing the public full and timely access to nonexempt records concerning the conduct of government, while remaining mindful of individuals’ privacy rights and the desirability of the efficient administration of Port business. These procedures will be guided by the provision of the Act describing its purposes and interpretation.
2) Merrill and Ring Renewal Options and Lease Credit
3) MTIP Site Preparation – Reid Middleton Agreement
See full agenda for further details
https://portofpa.com/AgendaCenter/ViewFile/Agenda/_10022017-270
CITY OF PORT ANGELES MEETING AGENDA HIGHLIGHTS
1) Solid Waste Transfer Station Rate Reduction
2) Resolution of Support for Clallam County Proposition No. 1, Tax for Juvenile Detention Facilities
(See full agenda for details)
http://wa-portangeles.civicplus.com/DocumentCenter/View/4196
OTHER LOCAL & REGIONAL MEETINGS...
CLALLAM COUNTY PUD AGENDA
https://www.clallampud.net/wp-content/uploads/2014/11/Board-Packet-10-2-17.pdf
JEFFERSON COUNTY COMMISSION MEETING AGENDA HIGHLIGHT
AGREEMENT NO. WQALG-2018-JeCoPH-00006 re: Lake Anderson Management Plan Water Quality Algae Control Program; In the Amount of $66,667; Jefferson County Public Health; Washington State Department of Ecology.
(see full agenda)
http://test.co.jefferson.wa.us/WebLinkExternal/0/edoc/1720920/A100217.pdf
CITY OF PORT TOWNSEND AGENDA HIGHLIGHT ITEMS
Ordinance 3182 Related to the Security of Publicly-Owned Property; Adopting a Process for Excluding Individuals whose Behavior is Unreasonably Disruptive, Establishing an Appeal Process to Protect Excluded Individuals’ Rights, Adopting a New Chapter 9.50 “Trespass Warnings On City And Other Publicly-Owned Property,” and Amending Chapter 11.01 of the Port Townsend Municipal Code
Action: Move to approve Ordinance 3182 Related to the Security of Publicly-Owned Property; Adopting a Process for Excluding Individuals whose Behavior is Unreasonably Disruptive, Establishing an Appeal Process to Protect Excluded Individuals’ Rights, Adopting a New Chapter 9.50 “Trespass Warnings On City And Other Publicly-Owned Property,” and Amending Chapter 11.01 of the Port Townsend Municipal Code.
(see full agenda for details)
http://cityofpt.granicus.com/GeneratedAgendaViewer.php?view_id=4&event_id=1142
OMC COMMISSION MEETING AGENDA
Olympic Medical Physicians Update – Joshua Jones, MD, OMP Chief Physician Officer
o Advance Practice Clinician Employment Agreement for Orthopedics
o Physician Employment Agreement for Primary Care
(see full agenda)
http://www.olympicmedical.org/pdfs/AGENDA%20-%20October%204%202017.pdf
WORLD AND NATIONAL NEWS BRIEFS FROM REUTERS....
North Korea seen moving missiles from development center: South Korean broadcaster
SEOUL (Reuters) - Several North Korean missiles were recently spotted moved from a rocket facility in the capital Pyongyang, South Korea’s Korean Broadcasting System (KBS) reported late Friday amid speculation that the North was preparing to take more provocative actions.
U.S. 'probing' to see if North Korea interested in dialogue: Tillerson
BEIJING (Reuters) - The United States is probing North Korea to see whether it is interested in dialogue and has multiple direct channels of communication with Pyongyang, U.S. Secretary of State Rex Tillerson said on Saturday.
Turkey's Erdogan says Iraqi Kurdish authorities "will pay price" for vote
ISTANBUL (Reuters) - Turkey’s President Tayyip Erdogan said on Saturday Iraqi Kurdish authorities would pay the price for an independence referendum which was widely opposed by foreign powers.
NATIONAL
Under pressure from Trump, Price resigns as health secretary over private plane uproar
WASHINGTON (Reuters) - U.S. Health and Human Services Secretary Tom Price resigned under pressure from President Donald Trump on Friday in an uproar over Price’s use of costly private charter planes for government business.
Trump interviews four for Fed chair job, to decide in two-three weeks
WASHINGTON (Reuters) - U.S. President Donald Trump is ramping up his search for a new chief for the U.S. central bank, meeting with former Federal Reserve Governor Kevin Warsh and three others and promising a decision next month.
Rich would benefit most from Trump tax cut plan: policy group
WASHINGTON (Reuters) - The wealthiest Americans would benefit the most from President Donald Trump’s proposed tax cuts while many upper middle-income people would face higher taxes, independent experts said on Friday in the first detailed analysis of the plan.
Daily Bible Verse: And this I pray, that your love may abound still more and more in knowledge and all discernment, that you may approve the things that are excellent, that you may be sincere and without offense till the day of Christ,
Philippians 1:9-10 NKJV
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