Multistate investigation probes whether opioid manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids
DES MOINES – A bipartisan group of state attorneys general, including Attorney General Tom Miller, is expanding a multistate investigation into the manufacturers and distributors of prescription opioid drugs as part of a widespread probe into the nation’s opioid epidemic.
The 40 states, plus the District of Columbia, served investigative subpoenas for documents and information, also known as civil investigative demands, on Endo, Janssen, Teva/Cephalon, and Allergan, and served a supplemental civil investigative demand on Purdue Pharma.
The attorneys general previously launched an investigation of Purdue Pharma. Miller’s office announced the multistate investigation in June, though at the time did not name the firm.
The states are also seeking documents and information about distribution practices from three pharmaceutical distribution companies—AmerisourceBergen, Cardinal Health and McKesson—which together manage approximately 85 percent of the nation's opioid distribution.
The information that state attorneys general seek will enable the states to investigate and evaluate whether manufacturers and distributors engaged in unlawful practices in the marketing, sale, and distribution of opioids.
The move represents a substantial expansion and coordination of investigations by the states into the opioid epidemic. A clear majority of the states' chief legal officers are now pooling resources and coordinating across party lines to address the most pressing public health crisis affecting our country, and doing so with a broad focus on multiple entities at both the manufacturer and distributor levels.
“The opioid epidemic is nothing short of a public health crisis that kills dozens of Iowans every year and more than 100 people a day nationwide,” Miller said. “Beyond those numbers, this epidemic profoundly impacts affected patients, their families, our communities, and our health care system,” Miller added. “As state attorneys general we can collaboratively use the law to investigate the cause and scope of this problem, and we can work together to help address it.”
Nationwide, opioids—prescription and illicit—are the main driver of drug overdose deaths. According to the Centers for Disease Control and Prevention’s latest report, opioids were involved in 33,091 deaths across the U.S. in 2015, and opioid overdoses have quadrupled since 1999.
Opioid Epidemic in Iowa
Over the last decade in Iowa, according to an Iowa Department of Public Health report issued in March on heroin and opioids, there have been “significant increases” in the number of Iowans identifying heroin and opioids as their drug of choice when they began seeking treatment, and in the number of overdose deaths.
The report shows that treatment admissions and overdose deaths associated with opioids over the last decade in Iowa have skyrocketed:
- Treatment Admissions: From 2005 to 2016, opioid-related treatment admissions jumped 274 percent (608 in 2005 to 2,274 in 2016).
- Overdose Deaths: From 2005 to 2016, opioid-related overdose deaths climbed 139 percent (28 in 2005 to 67 in 2016*), and opioid-related deaths rose 147 percent (59 in 2005 to 146 in 2016*). (The * denotes provisional data.)
Another report, issued in March by the University of Iowa’s Injury Prevention Research Center, found that prescription opioid use has reached “unprecedented” levels, and that “heroin use is a rapidly growing public health problem and is associated with non-medical use of prescription opioid pain relievers.” According to the report’s findings, “Rates of prescription drug deaths since 1999 have quadrupled (in Iowa), making it only one of four states with such a dramatic increase.”