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Opioid Update

Opioid Update. Nebraska Department of Justice Attorney General Doug Peterson. Opioid Crisis Timeline. CDC publish guidelines for prescribing opioids 2016. Improper use of Medicaid to obtain prescription opioids Since 2010. Purdue Pharma & executives plead guilty & have $600 mil in fines

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Opioid Update

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  1. Opioid Update Nebraska Department of Justice Attorney General Doug Peterson

  2. Opioid Crisis Timeline CDC publish guidelines for prescribing opioids 2016 Improper use of Medicaid to obtain prescription opioids Since 2010 Purdue Pharma & executives plead guilty & have $600 mil in fines 2007 1st wave of opioid overdose deaths began with prescribing in 1990s “Pain: The Fifth Vital Sign” 2000 1980s “Addiction Rare” published in the New England Journal of Medicine 1995 FDA approves labeling of OxyContin 2010 2nd wave of opioid overdose deaths ( heroin) 2003 FDA sends Purdue Pharma a warning letter re: OxyContin’s marketing 2013 3rd wave increases in overdose deaths (synthetic opioids)

  3. What are we looking for? The “Opioid” Multistate Investigation • Theories of Liability • Violations of: • State Consumer Protection Laws • State Controlled Substances Laws • Federal Controlled Substance Act • Federal Food, Drug and Cosmetic Act • State False Claims Laws

  4. Investigations of Opioid Manufacturers and Distributors 44 Attorneys General part of one or more { • Purdue Pharma: 38 AGs • Allergan, Endo, Janssen, and Teva: 36 AGs Nebraska is involved in all investigations • Mallinckrodt: 41 AGs • Amerisource, Cardinal, and McKesson: 39 AGs

  5. Current Opioid Litigation Overview • Multistate • State Law Suits • 21 states’ private lawsuits • Leaders: • Ohio • West Virginia • City & County • Lawsuits consolidated into MDL – Ohio Federal Circuit • 44 Attorneys General investigating manufacturers

  6. What remedies are being considered? The “Opioid” Multistate Investigation • Monetary Payments • 3 Buckets • Distribution will be based on metrics TBD • Unlikely that state AGs will control distribution • National Remediation Fund • Political Subdivisions • State AGs

  7. Nebraska Opioid Timeline Nebraska Coalition forms August 2016 AGO announces investigation to help address the opioid crisis June 2017 Summit report released October 2017 Strategic Initiative Report released October 2016 April 2018 Opioid update letter January 2016 36 AGs urge CDC to adopt prescribing guidelines September 2017 AGO seeks documents from opioid manufacturers & distributors October 2016 Opioid summit meets February 2017 Dose of Reality launched

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