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Last summer, a woman in northern Alabama who law enforcement officials said was a prostitute typed a message to a doctor: “Can u get any Xanax.” The doctor replied: “What makes you think I know a Xanax source?” Just below, he added a smiley face, and then described his home as the “Fun House.” The doctor was one of the scores of medical professionals across seven states who were charged by federal prosecutors on Wednesday with schemes to illegally distribute millions of pain pills. Opioid prescriptions were exchanged for sex in some cases, and for cash with an added “concierge fee” in others. One doctor was accused of routinely prescribing opioids to friends on Facebook. (Robertson, 4/17)

U.S. Attorney Benjamin Glassman of Cincinnati described the action, with 31 doctors facing charges, as the biggest known takedown yet of drug prescribers. Robert Duncan, U.S. attorney for eastern Kentucky, called the doctors involved "white-coated drug dealers." Authorities said the 60 includes 53 medical professionals tied to some 350,000 prescriptions and 32 million pills. The operation was conducted by the federal Appalachian Regional Prescription Opioid Strike Force, launched last year by the Trump administration. (Sewell, 4/17)

“The opioid epidemic is the deadliest drug crisis in American history, and Appalachia has suffered the consequences more than perhaps any other region,” Attorney General William P. Barr said in a statement. (Borter, 4/17)

“That is the equivalent of one opioid dose for every man, woman and child” in the region, Brian Benczkowski, an assistant attorney general in charge of the Justice Department’s criminal division, said in an interview. “If these medical professionals behave like drug dealers, you can rest assured that the Justice Department is going to treat them like drug dealers.” (Horwitz and Higham, 4/17)

The cases revealed in the indictment include a man in Tennessee who called himself the “Rock Doc” and allegedly prescribed hundreds of thousands of pills in exchange for sex; a doctor in Alabama who prosecutors say recruited prostitutes to become patients and let them use drugs at his house; another who wrote prescriptions on behalf of Facebook friends; and a dentist in Kentucky accused of needlessly pulling teeth to justify giving his patients addictive drugs. The charges against them include unlawful distribution of controlled substances and conspiracy to obtain controlled substances by fraud. (Gurman and Randazzo, 4/17)

Congressional investigations into the opioid epidemic have focused on the role of both manufacturers and drug distributors, as well as some of the early failings of the Drug Enforcement Administration to stop the flow of opioids into vulnerable rural areas. Thousands of cities, counties and Native American tribes have filed lawsuits targeting the entire drug supply chain. A recent multimillion-dollar settlement between the state of Oklahoma and Purdue Pharma could influence the lawsuits facing opioid companies across the country. (Weixel, 4/17)

How might Ohio better regulate hospitals following allegations that an intensive care doctor ordered excessive painkiller doses for dozens of patients who then died? That's the question facing officials in Ohio, the only state that doesn't license general hospitals. (4/17)

Drugged driving is a growing concern as more states legalize marijuana and the opioid epidemic rages on. To fight it, more communities are training police officers to draw drivers’ blood at police stations or in vans, as in Arizona. And on-call judges are approving warrants electronically, often in a matter of minutes at any time of day or night. ...While it’s easy for police to screen drivers for alcohol impairment using breath-testing devices to get a blood alcohol concentration level, there’s no such machine to screen for drug impairment. That’s why blood tests are so important, traffic safety experts say. (Bergal, 4/18)

Four months into its creation, Concord’s hub-and-spoke substance use treatment system is picking up some steam. Walk-in patients to Riverbend Community Health – the capital area’s “hub” – are up and 41 patients have been referred to services so far, the organization says. But as New Hampshire officials continue to roll out the program and present it as a key asset in turning around the state’s opioid epidemic, a growing difficulty looms: payments. (DeWitt, 4/17)