Cover 2 Resources

Last week, a STAT News article titled “Covid-19 will worsen the opioid overdose crisis if we don’t prepare now,” stated that, “Missing from the national discussion on the coronavirus has been another vulnerable group: patients with opioid use disorder. Despite ongoing public health efforts, the opioid overdose crisis does not appear to be slowing down. The emergency of Covid-19 could worsen it if we do not preemptively develop and implement response plans now.”

As we know all too well, social isolation is a key measure for preventing infection and curbing the spread of the virus. Many patients taking medications to treat their opioid use disorder — methadone or buprenorphine — aren’t able to stay home. Government regulations limit how these medications are prescribed and dispensed, often requiring inpatient treatment.

Here to talk about what’s being done for those in SUD treatment is Dr. Rick Massatti, the State Opioid Treatment Authority at the Ohio Department of Mental Health and Addiction Services (OhioMHAS). Dr. Massatti currently oversees the federally licensed opioid treatment programs (OTPs) and has over sixteen years of experience working on substance use and mental health research policies and programs.

As our state and nation pivot to address this crisis and vulnerable population, Dr. Massatti brings his expert understanding to this week’s podcast. Together, we shed light on the COVID-19 and the opioid treatment guidance policies, changing rapidly across the country.

Join us on this week’s podcast for eye-opening insights into COVID-19’s impact on the opioid epidemic and the rapid response policy changes saving lives as the coronavirus pandemic evolves.

In its latest Strategy Report, the Office of National Drug Control Policy (ONDCP) shared its strategy for building a stronger, healthier, drug-free society. To reach this goal, the ONDCP details three tactics for fighting the opioid epidemic.

First, continue to prevent new substance abusers through education and evidence-based prevention programs. Second, improve access to long-term addiction recovery treatment services. Third, reduce the availability of these drugs in our communities.

By achieving these goals, the ONDCP will dominate the drug environment, reducing future lives lost to substance use.

Today, we're joined by the Director of the ONDCP, Mr. Jim Carroll, the man in charge of executing this strategy. Together, we discuss the highlights of the latest Drug Control Strategy Report.

Join us on the latest episode of the Cover2 Resources Podcast for a deep dive into our nation's plan for fighting the opioid epidemic.

In June 2017, Dr. Belma Andric, Chief Medical Officer of the Health District of Palm Beach County, Florida, joined Greg on the Cover2 podcast. She shared a unique pilot program that started Medication Assisted Treatment (MAT) for overdose victims right in the emergency room (ER). Unlike previous MAT addiction programs, the pilot program included 8 days of house calls to deliver medication and monitor patient progress.

The success of that program inspired a new treatment initiative in Palm Beach County, an ER Addiction Stabilization Unit (ASU) specially designed for those struggling with substance use disorder (SUD). Since its inception, the ASU has treated over 350 patients. Similar to regional centers of excellence that address conditions such as heart, stroke, or cancer care, Palm Beach County now has the first center for evidence-based addiction care.

Just two weeks after the ribbon-cutting ceremony officially opening the ASU, Greg met with Dr. Andric and her team. Together, they introduced this ground-breaking program that, through a public-private partnership, leading the way in overdose treatment, life-long addiction care, and reducing the stigma surrounding addiction and addiction treatment.

Join us on this week’s podcast as Dr. Andric and her team share how they helped create the first ASU in Palm Beach County, Florida.

Since 1995, when the FDA approved OxyContin, igniting an opioid crisis, many bad actors have emerged willing to do almost anything to make a buck off the insatiable demand for opioids in our country. But none less known, and more destructive than Paul Le Roux.

Born in Zimbabwe, Le Roux was a loner who became an expert software developer. Then, in 2004 he launched what would become the largest network of internet pharmacies in the world, supplying painkillers to millions of Americans each year.

At the height of his operation, Le Roux was distributing up to 100 million doses of painkillers, roughly 25 percent of the annual volume of national drug store chains like Rite Aid.

While LeRoux stayed largely under the radar, in 2014, he caught the attention of award-winning investigative journalist Evan Ratliff, launching his research into LeRoux’s little-known underworld.

Over the next 4 years, Ratliff wrote: “The Mastermind: Drugs. Empire. Murder. Betrayal. The incredible true story of the decade-long quest to bring down Paul Le Roux—the creator of a frighteningly powerful Internet-enabled cartel who merged the ruthlessness of a drug lord with the technological savvy of a Silicon Valley entrepreneur.”

Joining us on today’s podcast, Evan Ratliff shares Paul Le Roux’s improbable story and his influence on the opioid epidemic.

Between 2004 and 2011, opioid abuse and dependence among delivering mothers in Ohio grew by 491%. As a consequence, cases of neonatal abstinence syndrome (NAS), where opioid exposed babies experience acute drug withdrawal following birth, became commonplace.

Babies who begin their lives suffering from NAS experience slower than normal development, and can suffer adverse effects from it for years.

The Maternal Opiate Medical Supports Plus project (MOMS Plus) was developed to improve care and outcomes for mothers and their unborn babies through wrap-around services, care coordinators, and tailored counseling.

The MOMS Plus program, launched in 2017, has already helped over 1,000 mothers get help for SUD and lowered the risk of opioid withdrawal following birth for their babies.

Today, Dr. Michael Marcotte and Jennifer Terry from Cincinnati Children's Hospital join Greg to share the highlights of the program.

In 1996, pain became the 5th vital sign in medicine, prompting doctors to rely on opioids for pain treatment. As a result, opioid prescriptions spiked over the next 15 years, causing hundreds of thousands of opioid addictions.

While many doctors were educated on opioid prescribing practices, what they didn’t know – and are still learning – were strategies for tapering patients off of these highly addictive drugs.

Something Dr. Travis Rieder, a Bioethicist at Johns Hopkins School of Public Health, had to figure out on his own while recovering from a nasty motorcycle accident.

Dr. Rieder recounts his experience with opioid dependency in his book, In Pain, and joins us today to share his story of opioid dependence, withdrawal, and recovery.

Listen to today’s podcast for a first-hand experience of this medical knowledge deficiency, and what must be done to fill the gaps in pain treatment.

In February of 2019, we interviewed Palm Beach Post reporters Pat Beall and John Pacenti, about the trial of former executives from opioid manufacturer Insys Therapeutics. They’d been accused of racketeering, bribing doctors to prescribe their high-powered opioid fentanyl spray, Subsys, to patients who didn’t need it.

A year later, the Insys executives have finally received sentences of 1 to 5 ½ years in prison. This is the first time big pharma execs have been convicted and sent to prison for racketeering. It’s arguable whether this sentence achieves justice for the 900-plus lives lost to opioid addiction that began with Subsys prescriptions. But, it does send a clear message to the rest of the pharmaceutical industry.

To share their insight into the Insys sentencing, Palm Beach Post reporters, John Pacenti and Pat Beall return to the podcast. Together, we break-down what this case means for the rest of the pharmaceutical industry and the questions that remain.

Last July, Major League Baseball fans were shocked when Tyler Skaggs, a rising star pitcher for the Los Angeles Angels, was found dead in his hotel room. The toxicology report indicated Skaggs had oxycodone, fentanyl and alcohol in his system, causing him to overdose.

The tragic loss of Tyler Skaggs left many people wondering how his drug abuse went undetected by Major League Baseball. But it quickly became a compelling motivator to change their approach to substance use disorder in the workplace.

Last month MLB announced its new drug testing policy, which will include mandatory opioid testing for all players. The current MLB drug program tests players for performance-enhancing drugs like anabolic steroids, and other so-called “drugs of abuse”, including opioids, only if they had “reasonable cause”. The new MLB testing policy shifts way from solely punishing drug abusers, to getting them the help they need, a refreshing change in policy that has never been attempted in professional sports before.

To help us better understand the new MLB drug testing policy, joining us is journalist Jared Diamond of the WSJ. His in-depth reporting on this issue provides an insider’s perspective on MLB’s sweeping changes to their drug testing policy.

In 2006, Purdue Pharma was under fire for falsely advertising the addictiveness of its opioid, OxyContin. Many families believed that handcuffs were the only justifiable punishment, and the Department of Justice (DOJ) seemed to agree.

Yet, somehow Giuliani Partners LLC managed to reach a settlement for Purdue Pharma and it’s top three executives. Effectively telling all of Big Pharma that the deaths of thousands of Americans were just the cost of doing business.

However, in August 2019, The Weekly, a New York Times documentary TV series, released an episode profiling a leaked prosecution memo. The memo detailed that government investigators believed Purdue Pharma knew OxyContin was fueling a rise in addiction and had damning evidence to prove it.

Why did this memo take more than a decade to come to light? Had its contents been exposed, would it have mitigated the opioid crisis? Who was behind the decision to settle with the drug manufacturer responsible for igniting our country’s worst health crisis in history?

We’re joined today by Paul Pelletier, the former Deputy Chief of the DOJ’s Fraud Section of Criminal Division, and by returning guests Dave Aronberg, State Attorney of Palm Beach County, and Chris McGreal, award-winning author of American Overdose, and opioid crisis expert.

Together, we explore what really happened with the proposed indictment of Purdue Pharma and their three top-ranking executives, and the lost opportunity to make them pay.

Tune in to our PPT podcast for an inside perspective on NYT’s leaked prosecution memo, and the many unanswered questions left by the 2006 case against Purdue Pharma.

In 2019 we released 45 new podcasts covering books from best-selling authors such as Dopesick from Beth Macy and American Overdose from Chris McGreal, to important developments such as the MDL and the J&J Oklahoma trial and people making headlines such as Joe Rannazzisi, former head of diversion control from the DEA. As I look back I realize how many amazing people, places and things we were lucky enough to profile on our series in 2019. The one that stood out for me, was episode 250, with Dr. Andrew Kolodny. Dr. Kolodny’ s candid insights into the policy missteps at the FDA that enabled an epidemic to grow out of control for over two decades were a revelation to me and I hope, to our listeners as well. So, as we close out 2019, we’re pleased to re-release an abbreviated version of our interview with Dr. Andrew Kolodny.

Today’s guest, Dr. Andrew Kolodny, is an authority on the opioid epidemic. As a Senior Scientist and, Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management, Dr. Kolodny has a deep-rooted interest in public health.

He began his career working for the New York City Department of Health and Mental Hygiene, helping develop and implement multiple programs to improve health and save the lives of New York City citizens. These initiatives included: city-wide buprenorphine programs, life-saving naloxone overdose prevention programs and emergency room-based screenings, and brief interventions and referrals to treatment (SBIRT) programs for alcohol and drug misuse.

Using his expert knowledge and vast experience fighting the opioid epidemic, Dr. Kolodny guides us through the FDA’s missteps that helped fuel our nation’s worst health crisis in history.

Join us on today’s podcast as we uncover the mistakes that helped perpetuate a growing opioid crisis and the missed opportunities to keep it in check.