�Թϲ�����

Physicians are prescribing fewer opioids and tracking prescriptions with greater frequency to address potential misuse, according to the American Medical Association. The numbers arrived in a report that appears to serve as an argument against proposed legislation that would impose federal mandates on clinical practices, such as limiting the number of days worth of an opioid that physicians can prescribe, or requiring physicians to use state prescription drug monitoring programs. (Johnson, 5/31)

The number of opioid prescriptions issued nationwide has dropped by 22 percent between 2013 and 2017, which a doctors group touted as progress in fighting the epidemic of opioid addiction. The report from the American Medical Association (AMA) finds there were 55 million fewer prescriptions over that time period and the number of prescriptions has dropped for five years in a row. (Sullivan, 5/31)

Federal indictments against Insys executives accuse them of using their speaker program to pay kickbacks to doctors for prescribing their powerful opioid spray, Subsys. [Steven] Simon, who was one of the top-paid speakers in the program, is facing three lawsuits related to his Subsys prescribing, and the FBI served a search warrant last year at the pain clinic where he worked. (Marso, 5/31)

Yet another former Insys Therapeutics (INSY) sales rep has pleaded guilty to bribing doctors to write prescriptions for the Subsys opioid painkiller, which contains fentanyl and carries a high risk of dependency. Michelle Breitenbach, 38, who worked in New Jersey for the drug maker, paid kickbacks and bribes to an unspecified number of physicians in the form of speaking fees for purported education events, according to the New Jersey attorney general. She faces up to five years in prison. (Silverman, 5/31)

Around 2015, just before overdoses sweeping the country started making national news, a pharmaceutical sales representative in New Jersey faced a dilemma: She wanted to increase her sales but worried that the opioid painkiller she was selling was addictive and dangerous. The medication was called Subsys, and its key ingredient, fentanyl, is a synthetic opioid 100 times stronger than morphine. When the rep, who requested to go by her initials, M.S., voiced her concerns to her manager, she was told that Subsys patients were “already addicts and their prospects were therefore essentially rock-bottom,” according to a recently unsealed whistleblower lawsuit that M.S. filed after leaving Insys in 2016. To boost her numbers, the manager allegedly advised M.S. to “behave more sexually toward pain-management physicians, to stroke their hands while literally begging for prescriptions,” and to ask for the prescriptions as a “favor.” (Lurie, 5/31)

Utah sued OxyContin maker Purdue Pharma LP after talks sponsored by state attorneys general failed to yield a settlement over the company’s handling of the opioid painkiller. Utah Attorney General Sean Reyes said Thursday that after months of negotiations in the so-called multi-state talks with Purdue about its role in the U.S. opioid epidemic, the negotiations were “no longer effective.” (Feeley, 5/31)

An attorney for Purdue Pharma, the company that makes the prescription opioid painkiller OxyContin, told an Alaska judge Thursday that there is an opioid crisis but the state has no legal basis for trying to pin that crisis on the company. (Bohrer, 5/31)

Philadelphia authorities on Wednesday cleared two tent camps where opioid users congregated, capping a monthlong effort to move people into treatment and shelters. Four tunnels filled with tents and mattresses beneath a freight railway have become highly visible symbols of the city’s drug problem, spilling out into Philadelphia’s Kensington neighborhood. Deeming the tunnels health and safety hazards, the city cleared two of them as part of a pilot project. (Kamp, 5/31)

As the death toll from the nation’s opioid crisis swells, California officials have launched an experiment: paying for people to test their drugs for fentanyl. Fentanyl, an opioid that is up to 50 times stronger than heroin, is responsible for a growing number of overdose deaths each year. Typically manufactured as a white powder, it can be mixed into other drugs such as heroin and cocaine without the user knowing, but with extreme consequences. (Karlamangla, 5/30)

Michael Marquesen, executive director of needle exchange Los Angeles Community Health Project, said distributing the strips allows him to warn people about fentanyl and teach them how to use the anti-overdose medication naloxone. The tests have shown that 40 percent of the heroin in Hollywood contains fentanyl, he said. “The overdose rates in Hollywood are through the roof,” Marquesen said. “They keep rising every month.” (6/1)

Arizona State University scientists will work with Tempe to detect opioids and other drugs in city wastewater, an exploration that could serve as an early warning system in the ongoing opioid crisis. The city and the ASU Biodesign Institute each will contribute $35,000 to study wastewater for opioids, cocaine, marijuana and other drugs as part of its efforts to monitor public health. (Brown, 5/31)

The DEA has already considered designating kratom a Schedule 1 drug — the same category occupied by heroin, ecstasy and cocaine — which would effectively ban it. Federal concerns about health risks and potential abuse of the supplement manifested in a public health advisory from the Food and Drug Administration last year that said the FDA was aware of reports of 36 deaths associated with the use of products containing kratom. (Gutierrez, 5/31)