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It’s hard to say whether businessman Kyle Graves hit rock bottom when he shot himself in the ankle so emergency room doctors would feed his opioid habit or when he broke into a safe to steal his father’s cancer pain medicine. For straight-talking ex-trucker Jeff McCoy, it was when he grabbed a gun and threatened to blow his brains out if his mother didn’t hand over his fentanyl patches. (Tanner, 11/20)

In late January 2012, drug distributor Cardinal Health got word that the Drug Enforcement Administration was about to take action against the company’s Lakeland, Fla., warehouse, which supplied 36 million opioid painkillers to customers in three Southern states every month. Large numbers of pills had been leaking onto the black market and Cardinal had failed to report warning signs to the DEA, agency records show. Cardinal was concerned that the DEA was about to hit the warehouse with an “immediate suspension order” — a tactic that instantly halts all commerce in controlled substances. (Bernstein and Higham, 11/17)

Oxycontin maker Purdue Pharma LP is proposing a global settlement in an attempt to end state investigations and lawsuits over the U.S. opioid epidemic, according to people familiar with the talks. Purdue’s lawyers raised the prospect with several southern-state attorneys general who haven’t sued the company, as they try to gauge interest for a more wide-ranging deal, said four people who asked not to be identified because the talks aren’t public. (Feeley and Hopkins, 11/17)

More than two dozen patients were rushed into an emergency room in Macon, Ga., over two days with the same array of life-threatening symptoms, including organ failure and sepsis, flummoxing doctors. But after their breathing tubes were removed, the patients revealed a common thread: All had taken what they believed were Percocet pills they had bought on the street. Although they looked like the prescription painkillers at first glance, the pills they took were nothing like what they expected. (Zezima, 11/19)

Drug overdoses killed 64,000 Americans last year — most of them involving painkillers or other opioids. Addiction experts are in wide agreement on the most effective way to help addicts: medication-assisted treatment. They say that wider adoption of this method would save lives. But most inpatient rehab facilities in the U.S. don’t offer this option, and there’s a shortage of doctors in rural areas that are able to prescribe these highly-controlled medications. (Bellini, 11/17)

The CMS proposed several changes aimed at combating opioid addiction among seniors and dual-eligibles and advancing the Trump administration's agenda of reducing regulatory burdens and increasing flexibility for health plans. The agency said the proposed changes to the Medicare Advantage program and Medicare Part D prescription drug plans for 2019 would save Medicare about $195 million a year over five years, helping to lower premiums and improve benefits for Advantage plan members. (Livingston, 11/17)

The opioid epidemic sweeping the U.S. is far costlier than once thought, with the economic impact of the crisis exceeding half a trillion dollars, according to a new report by White House economists. The epidemic cost the American economy $504 billion in 2015, which was the equivalent of 2.8 percent of gross domestic product that year, according to the report by the Council of Economic Advisers, or CEA. The White House’s figures are more than six times larger than a previous study because it incorporates the value of lives lost to the epidemic. (Woods, 11/19)

The economic cost of the opioid epidemic was about $504 billion in 2015, which is more than six times higher than other studies from previous years, according to a newly released analysis from the White House Council of Economic Advisers (CEA). This figure accounts for roughly 2.8 percent of gross domestic product. The opioid crisis has garnered the national spotlight, as it has led to a significant uptick in overdose deaths since 1999 and, most recently, was declared a national public health emergency by President Trump. (Roubein, 11/19)