Tuesday, June 26, 2018

60 Minutes on the opioid crisis #2

A question I had -- not at all answered by the 60 Minutes show-- is why any one drug distributor deserves so much blame. Suppose the following. A rogue pharmacy buys drugs from three different distributors. #1 sells the pharmacy N1 thousand pills, #2 sells it N2 thousand pills, and #3 sells it N3 thousand pills, all in the same time span. So the pharmacy buys N1 + N2 + N3 thousand pills. Why should #1 be held accountable for knowing about the N2 + N3 thousand pills? Similar for #2 and #3. Yet apparently Rannazzisi, the other DEA people, and 60 Minutes host Bill Whitaker seem to believe each of the three should be held accountable and far more to blame than the pharmacy, doctors who write the prescriptions, or the people who overdose. Are the people overdosing with opiods entirely innocent? How guilty are the doctors writing the prescriptions, and the pharmacies filling the prescriptions? Such doctors and pharmacies get a little blame, but it is far outweighed by the blame on the big wholesale drug distributors.

Whitaker claims the distributors know how exactly how many pills go to every drug store they supply (5:29), and the show cites large numbers of pills relative to the local population. Does that mean N1 or N1 + N2 + N3? Are some drug stores buying large quantities in order to supply other drug stores who can get lower prices this way?

Is it much easier for the DEA to go after the drug distributors and going after them is considered more newsworthy? There are thousands of doctors and hundreds of pharmacies and pain clinics, so many that it would be difficult to pursue massive arrests. On the other hand, there is a tiny number of large wholesale drug distributors. The DEA could slap a big fine on a big wholesale distributor company, but that could be chump change to the company and wouldn't be hugely newsworthy. That makes a high-level executive of a big drug distributor an easy target for scapegoating or maybe prosecution. Prosecuting such an executive would also likely be considered very newsworthy.

The drug distributors are supposed to report cases of a pharmacy that makes big orders to the DEA. McKesson and Cardinal Health did under-report and pay a big fine. Regardless, why assume they have obligations beyond that, e.g. knowing what a pharmacy buys from other distributors? Shouldn't any action beyond that be the DEA's responsibility?

The DEA zealots call the drug distributors greedy, non-caring killers. Would they accuse heroin or crack dope dealers of wanting to kill their customers? I doubt it. I don't doubt the distributors like their profits. On the other hand, I am confident that DEA folks dislike their actions being subject to limits. They desire their power as much as the drug distributors do their profit.

No comments:

Post a Comment