AG Ferguson Sues One Of The Nation’s Largest Opioid Manufacturers Over Washington’s Opioid Epidemic

WASHINGTON: Attorney General Bob Ferguson today filed a lawsuit accusing OxyContin maker Purdue Pharma of fueling the opioid epidemic in Washington state, embarking on a massive deceptive marketing campaign and convincing doctors and the public that their drugs are effective for treating chronic pain and have a low risk of addiction, contrary to overwhelming evidence. This deceptive marketing resulted in the deaths of Washingtonians and devastation to Washington families.

The lawsuit contends Purdue conducted an uncontrolled experiment on the American public without any reliable clinical evidence that opioids are effective at treating chronic pain. To doctors and patients, Purdue consistently downplayed the risks of addiction from long-term use and deceptively represented opioids as safe for treating long-term chronic pain.

Purdue’s deception yielded the company billions of dollars in profit nationwide from its opioid drugs. Ferguson’s lawsuit seeks to force Purdue to forfeit the Washington portion of those profits.

The City of Seattle filed a separate lawsuit today against Purdue, in addition to Teva Pharmaceuticals, Janssen Pharmaceuticals, Endo Pharmaceuticals and Allergan. The city and Ferguson announced their lawsuits together.

Both suits, filed today in King County Superior Court contend that Purdue’s illegal conduct contributed to excessive prescriptions and addiction, causing many addicted patients to look for other ways — including illegal means — to get more pills or to get heroin. A 2014 study found that nearly 80 percent of heroin users reported using prescription opioids prior to heroin.

By filing the state’s lawsuit, Ferguson has ended his participation in a multistate coalition investigating opioid manufacturers nationwide. Several states that have filed similar lawsuits are using outside attorneys to handle their cases. Washington is only the second state to handle its case internally.

“Purdue Pharma ignored the devastating consequences of its opioids and profited from its massive deception,” Ferguson said. “It’s time they are held accountable and pay for the devastation they caused.”

“I stand together with Attorney General Ferguson in fighting for justice for patients who were prescribed opioids and became addicted, because they were not irresponsible; they were deceived,” Seattle City Attorney Pete Holmes said. “Addiction to opioids and heroin does not stop at Seattle’s city limits. This is the city’s problem, the state’s problem, and everyone’s problem.”

“Most of our health care professionals want to do the right thing for patients, but some corporations sought to boost their bottom line to peddle opioids on false promises, which, in great part, created this crisis. These corporations must be held accountable. I appreciate the Attorney General taking this important step today,” Gov. Jay Inslee said. “This will help with some recompense so we can implement our state’s opioid response plan and my executive order with the goals to prevent the next generation from becoming addicted, to prevent overdoses and to treat people who have opioid use disorder, a true medical condition with an effective medical treatment.”

Purdue falsely claims that opioids improve long-term function, have a low addiction risk that can be managed or prevented and that increased doses of opioids do not pose significant additional risks to patients.

False claims of the safety, effectiveness of long-term use

Purdue aggressively marketed its opioids for chronic pain from conditions like headaches and low back pain, despite a lack of clinical evidence that they are effective and safe for long-term use. Despite Purdue’s efforts over more than two decades, the Centers for Disease Control & Prevention (CDC) noted in its 2016 guidelines that “there is no good evidence that opioids improve pain or function with long-term use.”

Other, safer options — like acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen — are effective and carry fewer risks, the CDC added.

False claims of low addiction risk and “pseudoaddiction”

Among its marketing claims, Purdue distributed thousands of videos and pamphlets claiming that opioid addiction occurred in less than 1 percent of patients. The number was not based on a clinical study, but rather a 1980 letter to the editor in the New England Journal of Medicine. The actual addiction rate is as high as 26 percent, according to the CDC.

A study sponsored by Purdue asserted that “opioids were well tolerated with only rare incidence of addiction,” and the need for higher and higher doses as patients built up a tolerance to opioids “was not a clinically significant problem when managing patients with opioids long-term.”

When signs of addiction appeared in patients, Purdue persuaded doctors that what appeared to be addiction was actually under-treatment of their pain, and to respond by increasing opioid dosages.

In marketing materials, Purdue told doctors and policymakers that “pain-relief seeking behavior can often be mistaken for drug-seeking behavior.”

The concept, called “pseudoaddiction,” was coined by Dr. J. David Haddox, who later became a Purdue executive. His theory was based on the case of a single cancer patient. No study has validated the theory of “pseudoaddiction.”

Despite a lack of evidence of “pseudoaddiction,” Purdue pushed this theory to convince doctors to give more drugs to patients who displayed signs of addiction, such as asking for early refills on their prescriptions or “doctor shopping” for additional prescriptions.

False claims on risks of overdoses

Opioids are most dangerous when taken long-term and when taken in high doses. In 2013, the FDA noted that research shows that risk of misuse and abuse is great for extended release long acting opioids and observed that these drugs are often used chronically.

Accordingly, the CDC recommends that physicians carefully reassess increasing opioid doses beyond 50 morphine milligram equivalents (MMEs), and avoid exceeding 90 MMEs per day. 

Overdose risk for opioids begins at very low doses and doubles when the daily dose is between 20 MMEs and 49 MMEs. By 100 MMEs, the risk of death increases by nine fold. Overall, 1 in every 550 patients started on opioid therapy died of opioid-related causes a median of 2.6 years after their first opioid prescription. That number increased to 1 in 32 for patients receiving 200 MMEs per day.

Purdue’s sales representatives were trained to reassure prescribers that there is “no ceiling” on the amount of OxyContin a patient could be prescribed.

Ignoring red flags

Purdue sales staff kept detailed records of prescriptions in Washington by prescriber, drug strength, quantity and other factors. Purdue then used that data to aggressively market its drugs to the highest prescribers in the state.

Washington state medical boards sanctioned some of these prescribers for failing to follow rules related to opioid prescriptions and putting patients at risk. The lawsuit alleges that, in several cases, Purdue salespeople ignored red flags and continued to target these providers with sales pitches.

Details of specific interactions between Washington state providers and Purdue representatives are redacted from the complaint because Purdue contends the information is competitively sensitive. Ferguson plans to file a motion to unseal this information to reveal to the public additional details about these interactions.

Violating previous court order

Purdue has faced court action before over its deceptive marketing of OxyContin.

A 2007 court order resulting from a consent judgment with Washington and 25 other states prohibited the company from making misleading statements regarding abuse, addiction or dependence in its marketing materials for OxyContin. Purdue also promised to create an Abuse and Diversion Detection Program to detect and take appropriate steps upon detecting “atypical” prescribing patterns — including reporting “pill mill” doctors to the authorities.

Despite the court order, Purdue has continued to engage in deceptive marketing and has remained silent about suspicious prescribers it should have reported.

Washington’s epidemic

Prescriptions and sales of opioids in Washington skyrocketed more than 500 percent between 1997 and 2011. In 2011, at the peak of overall sales in Washington, more than 112 million daily doses of all prescription opioids were dispensed in the state — enough for a 16-day supply for every woman, man and child in Washington. More than 18.2 million daily doses of oxycodone were distributed in Washington in 2015.

Geographic areas in Washington with higher rates of opioid prescriptions show a strong correlation with higher overdose rates.

For example, Cowlitz, Clallam, Mason and Snohomish counties had the highest opioid overdose death rates in the state, according to the state Department of Health. Those counties also had some of the highest opioid prescription rates in the state.

Between 2009 and 2014, Washington saw a 60 percent increase in opioid-related hospital stays, the fourth-highest increase in the nation, according to a June study by the Agency for Health Care Research and Quality.

In 2015, the number of overdose deaths in Washington exceeded the number of deaths from car accidents, or deaths from firearms — whether from suicide, homicide or accidental. The majority of drug overdose deaths in Washington between 2010 and 2015 — more than 6 out of 10 — involved an opioid.

Relief

Ferguson’s lawsuit seeks civil penalties and damages. Ferguson also asks the court to order Purdue to give up the profits it made in Washington as a result of its illegal conduct. Sales of Purdue opioids are worth billions every year nationwide, and Washington’s portion is expected to be in the millions.

The surrendered profits will be used to remediate the effects of Purdue’s misrepresentations of opioids, possibly funding treatment, education and more.

Assistant Attorneys General Tad Robinson O’Neill and Kate Barach are leading the case for Washington.

Earlier this year, the Attorney General’s Office hosted a summit on Washington’s opioid epidemic in partnership with the Washington State Patrol and the Washington Association of Prosecuting Attorneys.

Washington AG Ferguson Statement On Sessions Letter

WASHINGTON:  In response to a letter from U.S. Attorney General Jeff Sessions regarding Washington’s marijuana regulations, Attorney General Bob Ferguson offered the following statement:

“I was disappointed by Attorney General Sessions’ letter, which relies on incomplete, inaccurate and out-of-date information on the status of Washington’s marijuana regulations. I’m also disappointed that he has yet to accept my repeated invitations to meet in person to discuss this critical issue face to face. If he does accept, I look forward to providing him with a more complete picture of the robust regulatory program that exists in our state.

“Any action from the Department of Justice short of allowing our well-regulated, voter-approved system to continue is unacceptable. I will continue to defend the will of Washington voters.”

The Wink in Weed: How Redmond, Washington’s First Legal Pot Shop Will Forever Change The City That Bill Gates Built

By David Rheins

WASHINGTON: Redmond, Washington, is famously the home of Microsoft and Nintendo America, and less famously known as the Bicycle Capital of the World.  The affluent community is home to 60,000 residents, it’s quaint streets lined with upscale shopping choices providing a local population of techies and young families with all their daily needs: Starbucks Coffee, Hot Pot Donuts, Molly Moon’s Homemade Ice Cream, and now thanks to the opening of the town’s first legal pot shop — Always Greener Downtown – a fine selection of curated cannabis products.

Established by Redmond’s Jenny Carbon and Shauna Mindt, Always Greener Downtown is a gorgeous shop with natural woods and an organic design that feels more like a jewelry store than dispensary.  The new 502 store joins some 370 licensed marijuana retailers already operating in Washington State, but theirs is not just another pot shop opening.  Redmond is ground zero for Washington’s successful technology industry, and the town is home to many “Microsoft millionaires” and their compatriots who demand the best of mainstream American consumer culture.

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The inclusion of Always Greener Downtown – prominently located in the heart of Redmond’s shopping district — is a victory for cannabis normalization, and a testament to the tireless efforts of Jenny and Shauna and their many cannabis industry supporters who turned out to testify at the countless Redmond City Council Zoning board hearings. The seamless integration of a legal pot shop into the fabric of the community will forever change what it means to be a pot smoker in Redmond.

GrasshopperHub CEO Heidi Arsenault was customer #1 at opening of Always Greener Downtown

GrasshopperHub CEO Heidi Arsenault was customer #1 at opening of Always Greener Downtown

I sat down with Jenny Carbon, and asked her to reflect on the historic store opening.

Q: What does it feel like to be the first pot shop in Microsoft’s home town?

A: We love our local clientele, whether they be Microsofties, local small business or out-of-towners.  Our community has been underserved and unregulated for far too long and we are thrilled when we hear how happy people are that they no longer have to fight traffic to find their products.

Q: It took you 3 years after applying for your license to open your store.  Why was it so difficult?

A: Redmond had a moratorium, once that was lifted it was confirmed that there was NO retail zoning that fit the 1,000 ft. buffers. We had to file to amend the 2030 comprehensive plan to create zoning. We were put on a 18 month wait list, once our issue was heard it went to planning commission for months of discussion, then went to council for a public hearing. In the meantime, legislation passed that allowed for buffers to be reduced and council approved 100ft buffers from parks and playgrounds, which we have a plethora of in Redmond.

Q: Tell us about the store decor, and why you decided to spend so much money on natural materials and reclaimed woods.

A: Choosing materials that are eco-friendly and sustainable just takes a bit more intention, the cost was not much different than most other products out there, but choices are not as readily available, so we had to take the time to source the products. We felt that any way we could help to reduce our carbon footprint was worthwhile. We know that matters to Redmond and wanted to bring our “Always Greener” concept full circle.

Q: What kind of cannabis products will you carry?

A: We carry flower, concentrates and edibles. We have some paraphernalia in house but plan to expand our collection as we grow.

Q: Next to your 502 shop, you will soon be opening Always Greener Mercantile.   What are your plans for that space?

A: AG Mercantile will be a place to showcase our branded eco-friendly apparel line, as well as support our local merchants and artists. We will feature cannabis related products as well as other novelties and non-psychoactive forms of cannabis such as HEMP and CBD products.

Q: The artistic work of Michael Guttsen is featured in the space now.  Who is he and what is his relevance?

A: Michael Guttsen is an artistic genius. He was someone who understood our vision early on and brought what we were thinking and feeling to life through our brand expression. He has done a plethora of work over the years, in many media forms and perceives the world through a larger lens than I could ever imagine. We have danced to a similar drumbeat which has enabled us to develop a kinship and synergy the easily allows for visual creations to appear. He is our muse, and we are forever grateful.

Q: The town of Redmond is abuzz with excitement for a weekend-long grand opening celebration, complete with ribbon-cutting ceremony featuring local politicians, luminaries and industry VIPs. Can you share with us the schedule of festivities?

A: The Grand Opening Celebration begins at “High Noon” on Friday, March 3rd, 2017. 

Highlights include:

Friday

12:00

  • Joy Beckerman presents us with true hemp cord for our cutting ceremony.
  • City officials, OneRedmond, as well as Redmond Reporter will join us for the cutting followed by cakes by Lisa Dupar catering (owner of Pomegrate Bistro, a Redmond favorite).

12:00-3:00

  • Hans Brehmer (jazz pianist) with guest Bassist & our very own Shauna Mindt accompanying them on tap!

Vendors:

12:00-3:00

  • Green Barn Farms

3:00-6:00

  • Washington Bud Co

6:00-9:00

  • Dynamic Harvest
  • Galaxy Donuts (and more!) 3-6pm

Saturday

12:00-5:00

  • Peach and the Pig Food Truck- Incredible pork sandwiches
  • Hans Brehmer (jazz pianist) with guest Bassist

4:00-6:00

  • Joe Duce of Trainwreck for some good old Grateful dead and classic rock

Vendors:

12:00-3:00

  • Mother Earth Farms

3:00-6:00

  • Hemp Zen
  • Ionic

6:00-9:00

  • Bad Ass Grass

Sunday

12:00-2:00

  • African drumming with Alex and friends
  • Espresso cart
  • Top Pot Donuts

Vendors:

10:00-1:00

  • Bondi Farms

1:00-3:00

  • Willie’s Reserve

 

Marijuana Advocates Tell Senators #JustSayNoToSessions

DISTRICT OF COLUMBIA: Yesterday, the National Organization for the Reform of Marijuana Laws (NORML) and its supporters organized a “Day of Action” to mobilize opposition to the appointment of Alabama Sen. Jeff Sessions as US Attorney General.

“Senator Sessions’ views are out of step with mainstream America and they are in conflict with laws throughout a majority of states,” stated NORML Executive Director Erik Altieri, “We must demand that Senators on the Judiciary Committee ask this nominee whether he intends to respect the will of the voters in these states and whether he truly believes that no ‘good people’ have ever smoked pot. If he truly believes such outdated Reefer Madness rhetoric, then he should not be the next Attorney General.”

Participants from over the country flooded their Senators phone lines to demand that if Senator Sessions refuses to agree to respect state marijuana laws, members of the Senate should refuse to confirm him as Attorney General. The effort was promoted online with the hashtag #JustSayNoToSessions.

If confirmed by the US Senate, Sen. Sessions will possess the power to roll back decades of hard-fought gains. He will have the authority to challenge the medical marijuana programs that now operate in 29 states and the adult use legalization laws that have been approved in eight states.

Attorney General Nominee Will Not Support Marijuana Legalization

DISTRICT OF COLUMBIA: On day one of her confirmation hearing to become the country’s next Attorney General, U.S. Attorney Loretta Lynch took an explicit stance against marijuana legalization.

When asked by Sen. Jeff Sessions (R-AL) if she supports legalization, Lynch responded “No I do not.” When Sessions probed her on President Obama’s position on marijuana, Lynch continued, “I can tell you that not only do I not support legalization of marijuana, it is not the position of the Department of Justice currently to support the legalization nor would it be the position should I become confirmed as Attorney General.”

The Justice Department’s current policy, as Lynch notes, does not extend to full legalization. Nevertheless, the department has taken significant steps to roll back prosecutions of marijuana users (and even, in some cases, distributors) who comply with state law. Fully legalizing marijuana would require an act of Congress (although the Obama Administration could take even more significant steps in that directionby rescheduling the drug).

Current federal law states that marijuana use is a federal offense, despite state efforts to legalize and decriminalize it. In recent years, there has been a push for pot’s medicinal use. More than 75 percent of all doctors say they would prescribe marijuana for health purposes. And nationwide, activists contend that decriminalizing and legalizing possession will benefit African-Americans who face racial disparities across the criminal justice system. According to the ACLU, black people are 3.73 more likely to be arrested than white people who use cannabis.