Drugmaker Endo strikes $63 million opioid settlement with Texas

By Nate Raymond

(Reuters) -Endo International Plc has agreed to pay $63 million to resolve claims by the state of Texas and local governments that the drugmaker helped fuel the U.S. opioid epidemic, the state’s attorney general said on Thursday.

The deal announced by Texas Attorney General Ken Paxton marked the latest in a series of settlements that Endo has struck in recent months with state and local governments to resolve similar cases.

More than 3,400 lawsuits largely by state and local governments have been filed nationally accusing Endo of contributing to the drug abuse crisis by deceptively marketing pain medications including Opana ER, which it no longer sells.

“This settlement is a necessary step in the right direction, and we will continue to fight to heal our state from this devastating crisis,” Paxton said in a statement.

Endo did not immediately respond to a request for comment.

Thousands of lawsuits have been filed seeking to hold drugmakers, drug distributors and pharmacy chains responsible for a drug abuse crisis the U.S. government says has led to hundreds of thousands of overdose deaths over two decades.

Drug distributors McKesson Corp, AmerisourceBergen Corp and Cardinal Health Inc and the drugmaker Johnson & Johnson are pushing to finalize proposed settlements of up to $26 billion to resolve the cases against them.

Endo is not part of the proposed $26 billion deal, but previously agreed to settle lawsuits by states or counties in Alabama, Louisiana, New York, Ohio, Oklahoma and Tennessee for more than $136 million.

In November, a California judge following a trial found Endo and three other drugmakers not liable in a lawsuit by several large counties that accused them of fueling the opioid epidemic, saying they failed to prove their $50 billion case.

(Reporting by Nate Raymond in Boston; Editing by Mark Porter and Diane Craft)

Oklahoma court overturns $465 million opioid award against Johnson & Johnson

By Nate Raymond

(Reuters) – The Oklahoma Supreme Court on Tuesday overturned a $465 million judgment against Johnson & Johnson in a lawsuit by the state alleging the drugmaker fueled the opioid epidemic through the deceptive marketing of painkillers.

The court on a 5-1 vote ruled that the state’s public nuisance law does not extend to the manufacturing, marketing and sales of prescription opioids and that a trial judge went too far in holding that it did.

J&J had no immediate comment. A spokesperson for Oklahoma Attorney General John O’Connor did not immediately respond to a request for comment.

The decision marked the latest setback for states and local governments pursuing lawsuits seeking to hold drug companies responsible for a drug abuse crisis the U.S. government says led to nearly 500,000 opioid overdose deaths over two decades.

The case against J&J by Oklahoma’s attorney general was the first to go to trial nationally of more than 3,000 similar cases against pharmaceutical manufacturers, drug distributors and pharmacies.

A similar trial in California pitting several large counties against J&J and three other drugmakers resulted in a judge on Nov. 1 ruling in the companies’ favor and concluding the epidemic could not be considered a public nuisance.

(Reporting by Nate Raymond in Boston,; Editing by Franklin Paul and Bernadette Baum)

Drug distributors strike 1st opioid settlement with Native American tribe for $75 million

By Nate Raymond

(Reuters) -The three largest U.S. drug distributors will pay more than $75 million to resolve claims they fueled an opioid epidemic in the Cherokee Nation’s territory in Oklahoma, marking the first settlement with a tribal government in the litigation over the U.S. addiction crisis.

Cherokee Nation Principal Chief Chuck Hoskin on Tuesday said the settlement, which will be paid over 6-1/2 years, would “enable us to increase our investments in mental health treatment facilities and other programs to help our people recover.”

The deal announced by the Cherokee Nation came after distributors McKesson Corp, AmerisourceBergen Corp and Cardinal Health Inc, along with the drugmaker Johnson & Johnson, agreed to pay up to $26 billion to resolve similar claims by states and local governments.

That settlement did not cover any of the country’s Native American tribes. The three distributors are in talks to resolve those cases, and other companies continue to face similar lawsuits.

Drugmakers Teva Pharmaceutical Industries Ltd and Endo International Plc on Tuesday separately said they agreed to pay $15 million and $7.5 million, respectively, to resolve claims they contributed to the opioid epidemic in Louisiana. Teva will also donate $3 million worth of medications.

The distributors in a statement called the deal “an important step toward reaching a broader settlement with all federally recognized Native American tribes across the country.” The companies deny wrongdoing.

The Cherokee Nation became the first Native American tribe to sue drug distributors and pharmacy operators in 2017. The sovereign Cherokee Nation has more than 390,000 citizens.

It accused the distributors of flooding its territory with millions of prescription opioid pills, an oversupply of addictive painkillers that resulted in abuse and overdose deaths that disproportionately affected Native Americans.

More than 3,300 similar lawsuits have been filed by states, counties, cities and tribal governments. Nearly 500,000 people died due to opioid overdoses in the United States from 1999 to 2019, according to the U.S. Centers for Disease Control and Prevention.

The Cherokee Nation, represented by the law firms Boies Schiller Flexner, Fields PLLC, and Whitten Burrage, also sued pharmacy operators CVS Health, Walgreens Boots Alliance Inc and Walmart Inc. They deny wrongdoing.

(Reporting by Nate Raymond in BostonEditing by Bill Berkrot)

New York, drug distributors reach $1.18 billion opioid settlement as national deal looms

By Brendan Pierson and Nate Raymond

NEW YORK (Reuters) -The three largest U.S. drug distributors agreed mid-trial to pay up to $1.18 billion to settle claims by New York state and two of its biggest counties over their role in the nationwide opioid epidemic, the state’s attorney general said on Tuesday.

McKesson Corp, Cardinal Health Inc and AmerisourceBergen Corp settled as state attorneys general prepare to announce as soon as this week a landmark $26 billion deal with the distributors and drugmaker Johnson & Johnson resolving cases nationwide.

The deal with New York Attorney General Letitia James and the populous Long Island counties of Nassau and Suffolk came three weeks into the first jury trial accusing companies of profiting from a flood of addictive painkillers that devastated communities.

“While no amount of money will ever compensate for the millions of addictions, the hundreds of thousands of deaths, or the countless communities decimated by opioids, this money will be vital in preventing any future devastation,” James said.

Hunter Shkolnik, a lawyer for Nassau County at the law firm Napoli Shkolnik, in a statement said that unlike the proposed national settlement, the New York deal “is not contingent on the rest of the country or other states joining.”

In a joint statement, the distributors called the settlement “an important step toward finalizing a broad settlement with states, counties, and political subdivisions.”

‘GETTING CLOSE’ ON NATIONAL SETTLEMENT

The national settlement is expected to be announced later this week, people familiar with the matter said. Joe Rice, a lead negotiator for lawyers for the cities and counties at Motley Rice, told reporters the parties are “getting close” to finalizing a deal.

After the framework is announced, states and their subdivisions will need to decide whether to join the global accord, the sources have said. The ultimate settlement price-tag could fluctuate depending on how many agree to the deal or reject it to pursue litigation on their own.

The settlement also calls the creation of a national clearinghouse of data on opioid shipments operated under the oversight of an independent third-party monitor.

Paul Geller, a lead negotiator for the plaintiffs at Robbins Geller Rudman & Dowd Geller, said that provision would be “transformative” in battling drug oversupply.

Nearly 500,000 people died from opioid overdoses in the United States from 1999 to 2019, according to the U.S. Centers for Disease Control and Prevention. The CDC last week said provisional data showed that 2020 was a record year for overall drug overdose deaths with 93,331, up 29% from a year earlier.

REMAINING DEFENDANTS

More than 3,300 cases have been filed largely by states and local governments alleging drugmakers falsely marketed opioid painkillers as safe, and distributors and pharmacies of ignoring red flags that they were being diverted to illegal channels.

The New York trial will continue against three drugmakers accused of deceptively marketing their painkillers – Endo International Plc, Teva Pharmaceutical Industries Ltd and AbbVie Inc’s Allergan unit.

Ahead of the trial, Johnson & Johnson agreed to pay $263 million to resolve the claims by the state and counties. Pharmacy operators Walgreens Boots Alliance Inc, CVS Health Corp, Rite Aid Corp and Walmart Inc agreed to settle with the counties for a combined $26 million.

Two other opioid cases are also on trial in West Virginia and California. The companies have denied wrongdoing.

James’ office said that of the nearly $1.18 billion the distributors agreed to pay, more than $1 billion will go toward addressing the epidemic. The counties have said the money will be used for mental health and addiction programs.

Payments will start in two months and will continue over the next 17 years, James said.

(Reporting by Brendan Pierson in New York and Nate Raymond in Boston; Editing by Tom Hals, Chizu Nomiyama, Bill Berkrot and Nick Zieminski)

How poor regions lose out because of U.S. census undercounts

By Nick Brown

ESPANOLA, New Mexico (Reuters) – Getting an accurate count of America’s population has proven difficult in the 2020 Census as the coronavirus pandemic has hampered voluntary responses and forced officials to scale back door-knocking efforts.

The administration of President Donald Trump has placed other hurdles on the path to an accurate count. Its attempt to add a question about citizenship to the census earlier this year likely discouraged undocumented immigrants from filling out the survey, even though the administration’s effort failed, demographics experts say. Local officials nationwide worry about the impact of undercounts on their communities.

“This is going to be the worst response rate we’ve ever had,” said Lauren Reichelt, Health and Human Services Director for Rio Arriba County, New Mexico.

Rio Arriba is typical of other regions across the United States that are hardest to count – and have the most to lose from an undercount. It’s poor, rural and home to many undocumented immigrants. Low population tallies can rob such areas of badly needed federal dollars for affordable housing and child care, for instance, or resources to fight America’s opioid epidemic, according to local officials in some of the most undercounted regions in the last census, taken in 2010.

“Persistent undercounting in communities that would benefit most from targeted public and private investment makes it harder to address the very barriers that contribute to a less accurate census,” said Terri Ann Lowenthal, a consultant on census and statistical issues and former congressional staffer overseeing census matters.

The Census Bureau and the White House declined to comment for this story.

The Bureau is nearing the end of the 2020 edition of the decennial count, which will guide the allocation of $1.5 trillion a year in federal aid. The census is also a linchpin of American democracy because the population counts are used to determine the number of Congressional representatives assigned to a state and to draw maps of electoral districts.

Some of the hardest-to-count regions in the last census might be even harder to survey this year as the country reels from the coronavirus pandemic, according to a Reuters analysis of Census data. They include border areas in Texas, the lowlands of Mississippi and the northern plains of New Mexico.

‘I ALWAYS RELAPSE’

Rio Arriba officials estimated they were undercounted by 4% in 2010, after only 42% of households mailed back their census forms voluntarily. That compared to 66.5% of households that responded by mail nationally, according to Census data.

The bureau sent door-knockers to get more responses, but still had to use a Census process called imputation to estimate residency for 9.6% of Rio Arriba’s count, a far larger proportion than the national average.

Officials in the county say an accurate count would have helped narrow funding gaps that leave it without enough medicine, detox clinics, housing and other support to fight one of the community’s biggest problems: an opioid epidemic that kills people at a rate more than four times the U.S. average, according to government data.

The current U.S. Census shows no signs of reversing the trend. Rio Arriba’s voluntary response rate is running at 32%, 10 points below its 2010 rate and less than half the overall U.S. rate of 67%.

It is impossible to know exactly how much funding is lost due to an undercount, says George Washington University professor Andrew Reamer, the nation’s foremost expert on the relationship between the census and federal spending. That would require knowing exactly how many people were missed and which government programs would have served them.

Officials in Rio Arriba agree they were entitled to more federal funds for programs to address a local opioid crisis.

“A lot of the funding for my department is federal, so we end up being entitled to a lot less than we should when there’s an undercount,” said Reichelt.

The $3.4 million her department received in 2020 to fight addiction is spread thin, and even a relatively modest increase could make a big difference. The county can’t afford to build a detox center, and patients wait for weeks to get suboxone, a drug that reduces withdrawal symptoms, Reichelt said.

The Rio Arriba County Housing Authority, meanwhile, manages 54 public housing units, and assists another 25 families with rent vouchers. But the wait lists can be as long as five years, according to Reichelt.

Joey Garcia, a 32-year-old heroin addict who has been in and out of jail on drug charges, said he has struggled to get straight while on waiting lists for both subsidized housing and suboxone treatment.

“Somehow,” Garcia said, “I always relapse.”

NERVOUS TO ANSWER

The Rio Grande Valley in south Texas is a political netherworld. North of the border but south of immigration checkpoints, its four counties – Hidalgo, Cameron, Starr and Willacy – include informal communities known as colonias, often heavily populated with undocumented immigrants.

In Hidalgo, officials estimate they were undercounted by at least 10% in 2010, after just 56% of the population responded voluntarily. The Census Bureau estimated a more modest 5.4% undercount.

Either way, the undercounts reduced funding to the area’s Head Start and Low Income Heating and Energy Assistance (LIHEAP) programs, which cover only a fraction of eligible residents.

In Pueblo de Palmas, a colonia in Hidalgo County, Cristina, 35, qualifies for government-funded Head Start childcare for her four children, but only one was admitted. She asked that only her first name be used because she is an undocumented immigrant.

Both LIHEAP and Head Start are underfunded in the county. The former has a budget of $6 million, enough to serve 3-4% of qualifying households, says Jaime Longoria, the region’s community services director.

Head Start, which relies on population data to decide where to expand programs, can serve 3,700 kids in Hidalgo out of 22,000 who qualify, said Teresa Flores, the local Head Start director. An accurate count would help cover some of that gap, she said.

Cristina and her neighbor, Maria – also undocumented – both said they couldn’t remember filling out a census form in 2010 and that they were afraid to do so this year.

“I’m nervous someone will come to my house and take me away,” Maria said.

‘WE’RE BROKE’

In central Mississippi, voluntary participation in the 2010 census ranged between 45% and 60%. The rate in these areas so far this year is similar, according to Census data.

Lower funding from census undercounts has affected a crucial childcare program for low-income mothers in the nation’s poorest state, program officials said.

More than 112,000 Mississippi families are poor enough to qualify, but the program only has enough money to grant 20,000 to 25,000 vouchers, said Carol Burnett, who runs the nonprofit Mississippi Low Income Childcare Initiative.

Mississippi’s allotment under the Child Care and Development Block Grant that funds the program was $91.8 million in fiscal year 2019. An extra 1% of that total statewide – about $918,000 – could potentially serve hundreds more parents across the state, Burnett said, as the vouchers cover around $5,700 a year in expenses.

Tanisha Womack, 35, runs three daycare centers in Simpson and Smith counties, two of several counties in Mississippi that were among the hardest to count nationwide in 2010, according to the Reuters data.

Womack is certified to care for 152 children, but has just 72 children enrolled, she said, because many qualifying parents have been denied vouchers.

“We’re broke,” Womack said.

(Reporting by Nick Brown; Additional reporting by Grant Smith; Editing by Richard Valdmanis and Brian Thevenot)

Several states wary of $48 billion opioid settlement proposal

Several states wary of $48 billion opioid settlement proposal
By Tom Hals and Nate Raymond

(Reuters) – Several U.S. states that have been ravaged by the opioid epidemic are pushing back on a proposed $48 billion settlement framework that would resolve thousands of lawsuits against five drug companies accused of fueling the addiction crisis.

The proposal would bring an end to all opioid litigation against AmerisourceBergen Corp<ABC.N>, Cardinal Health Inc<CAH.N> and McKesson Corp<MCK.N>, drugmaker Teva Pharmaceutical Industries Inc<TEVA.TA><TEVA.N>, and Johnson & Johnson<JNJ.J>.

The companies have proposed paying $22.25 billion cash mostly over 18 years, while services and drugs to treat addiction valued at $26 billion by the companies would be provided over the coming decade, mostly by Teva.

Officials in states such as Ohio, New Hampshire and West Virginia — all hard hit by the deadly drug addition crisis — voiced concerns about the proposal.

James Boffetti, the associate attorney general for New Hampshire, said in an interview he was troubled that payments were stretched over many years.

“The concern is, I think, the states need money now to create the infrastructure for treatment,” he said.

Small states fear the money will be divvied up by population rather than need.

“Any global opioid settlement that doesn’t reflect the unique and unprecedented damage imposed on West Virginia through the opioid epidemic should be DOA,” West Virginia Attorney General Patrick Morrisey said on Twitter on Tuesday.

Some 400,000 U.S. overdose deaths between 1997 and 2017 were linked to opioids, according to government data. Roughly 2,600 lawsuits have been brought nationwide by states, local and tribal governments.

The three distributors in a joint statement said they were committed to finalizing a global settlement and would continue working with the other parties on the details of the framework. Teva declined to comment.

J&J said in a securities filing on Wednesday the deal would lower third quarter profit by $3 billion.

The proposal, announced on Monday, was hammered out by the companies and attorneys general in North Carolina, Pennsylvania, Tennessee and Texas.

It will need broad support among state attorneys general and will have to overcome opposition from the lawyers representing local governments that sued. Those lawyers declined to sign on when presented the proposal last week.

Under the settlement framework, money for each state would be divvied up, with 15% going to the state treasury, 15% for local governments that filed lawsuits and 70% going to a proposed state fund aimed at addressing the crisis.

Boffetti predicted it would takes weeks for states to determine whether they back the settlement framework.

North Carolina’s attorney general, Josh Stein, acknowledged that a detailed term sheet needs to be developed.

“There are a lot of details and mechanics that need to be added to it,” Stein told Reuters in an interview. “That will happen in the coming weeks.”

The proposal did win a major supporter on Tuesday. Tom Miller of Iowa, the longest-serving attorney general, publicly backed the proposal, calling the framework “an important step in addressing the crisis.”

Colorado’s attorney general, Phil Weiser, called it a “very promising development.”

The lawsuits accuse distributors of failing to flag and halt a rising tide of suspicious orders and drugmakers of overstating the benefits of opioids while downplaying the risks.

The companies have denied any wrongdoing. Drugmakers say their products carried government-approved labels that warned of the addictive risks of opioids, while distributors argue their role was to make sure medicines prescribed by licensed doctors were available for patients.

The proposed deal has widened a fault line between attorneys general and local governments.

Cities and counties generally hired private attorneys to bring their cases, and attorneys general want to limit the amount of the settlement that goes to pay private lawyers. The attorneys for local governments also generally opposed Teva contributing opioid treatment drugs to the settlement, instead of cash, in part because of concerns that the framework placed an inflated value on those drugs.

Last week’s talks failed to reach a global deal, and on Monday, the three wholesale distributors and Teva struck a last-minute $260 million settlement with two Ohio counties, averting the first federal trial over opioids.

North Carolina’s Stein said he looked forward to resolving concerns about the proposal and warned that settling lawsuits individually was unsustainable.

“If we proceed on the current path and each county and city brings their case and extracts whatever amount they may be able to get from these companies, the companies will end up bankrupt,” he said. “The opioid crisis is a national problem that demands a national solution.”

(Reporting by Tom Hals in Wilmington, Delaware and Nate Raymond in Boston, Massachusetts; Editing by Noeleen Walder and Sandra Maler)

U.S. government gives states nearly $2 billion to combat opioid crisis

FILE PHOTO: An exterior view of the United States Health and Human Services Building on C Street Soutwest in Washington, U.S., July 29, 2019. REUTERS/Tom Brenner

(Reuters) – The U.S. Department of Health and Human Services (HHS) said on Wednesday it will offer states more than $1.8 billion in new funding to fight the opioid epidemic.

The funds will be used for expanding access to treatments for opioid overdosing and to gather case data from across states, the HHS said.

The Centers for Disease Control and Prevention will spend $900 million over three years – about $301 million in the first year – to help states and territories track overdose data as closely as possible, the HHS said https://www.hhs.gov/about/news/2019/09/04/trump-administration-announces-1-8-billion-funding-states-combating-opioid.html in a statement.

Meanwhile, HHS unit Substance Abuse and Mental Health Services Administration is awarding about $932 million to support prevention, treatment and recovery services.

Prescription opioid pain treatments and drugs like heroin and the more potent fentanyl were responsible for 47,600 U.S. deaths in 2017, according to the government, with only a small decline last year.

Drugmakers such as Johnson & Johnson and Endo International Plc are facing several lawsuits brought by states, counties and municipalities that seek to hold the companies responsible for opioid abuse nationwide.

A U.S. judge on Tuesday rejected efforts by major drugmakers, pharmacies and distributors to dismiss claims that they caused the nation’s opioid crisis, clearing the way for a landmark trial even as the judge pushes for a nationwide settlement.

(Reporting by Manas Mishra in Bengaluru; Editing by Shinjini Ganguli)

U.S. charges hundreds in major healthcare fraud, opioid crackdown

U.S. Attorney General Jeff Sessions addresses a news conference to announce a nation-wide health care fraud and opioid enforcement action, at the Justice Department in Washington, U.S. June 28, 2018. REUTERS/Jonathan Ernst

By Nate Raymond

(Reuters) – The U.S. Justice Department on Thursday announced charges against 601 people including doctors for taking part in healthcare frauds that resulted in over $2 billion in losses and contributed to the nation’s opioid epidemic in some cases.

The arrests came as part of what the department said was the largest healthcare fraud takedown in U.S. history and included 162 doctors and other suspects charged for their roles in prescribing and distributing addictive opioid painkillers.

“Some of our most trusted medical professionals look at their patients – vulnerable people suffering from addiction – and they see dollar signs,” U.S. Attorney General Jeff Sessions said.

The arrests came as part of an annual fraud takedown overseen by the Justice Department. The crackdown resulted in authorities bringing dozens of unrelated cases involving alleged frauds that cost government healthcare programs and insurers more than $2 billion.

Officials sought in the latest crackdown to emphasize their efforts to combat the nation’s opioid epidemic. According to the U.S. Centers for Disease Control and Prevention, the epidemic caused more than 42,000 deaths from opioid overdoses in the United States in 2016.

In a report released on Thursday, the U.S. Department of Health and Human Services’ Office of Inspector General said about 460,000 patients covered by Medicare received high amounts of opioids in 2017 and 71,000 were at risk of misuse or overdose.

Those figures were slightly down from 2016, but the report said the high level of opioid use remained a concern. The report said almost 300 prescribers had “questionable prescribing” that warranted further scrutiny.

Many of the criminal cases announced on Thursday involved charges against medical professionals who authorities said had contributed to the country’s opioid epidemic by participating in the unlawful distribution of prescription painkillers.

The cases included charges in Texas against a pharmacy chain owner and two other people accused of using fraudulent prescriptions to fill bulk orders for over 1 million hydrocodone and oxycodone pills that were sold to drug couriers.

“The perpetrators really are despicable and greedy people,” U.S. Health and Human Services Secretary Alex Azar said at a press conference.

The Justice Department also announced other cases unrelated to opioids, including schemes to bill the government healthcare programs Medicare, Medicaid and Tricare as well as private insurers for medically unnecessary prescription drugs and compounded medications.

(Reporting by Nate Raymond in Boston; Editing by Chizu Nomiyama and Tom Brown)

Trump declares opioids a U.S. public health emergency

Trump declares opioids a U.S. public health emergency

By Yasmeen Abutaleb and Jeff Mason

WASHINGTON (Reuters) – U.S. President Donald Trump declared the opioid crisis a public health emergency on Thursday, stopping short of a national emergency declaration he promised months ago that would have freed up more federal money.

Responding to a growing problem wreaking havoc in rural areas, Trump’s declaration will redirect federal resources and loosen regulations to combat opioid abuse, senior administration officials said on a conference call with reporters.

But it does not mean there will be more money to combat the crisis. Some critics, including Democratic lawmakers, said the declaration was meaningless without additional funding.

“This epidemic is a national health emergency,” Trump said at the White House. “Nobody has seen anything like what’s going on now. As Americans, we cannot allow this to continue.”

The announcement disappointed some advocates and experts in the addiction fight, who said it was inadequate to fight a scourge that played a role in more than 33,000 deaths in 2015, according to the U.S. Centers for Disease Control and Prevention. The death rate has kept rising, estimates show.

Opioids, primarily prescription painkillers, heroin and fentanyl, are fueling the drug overdoses. More than 100 Americans die daily from related overdoses, according to the CDC.

A White House commission on the drug crisis had urged Trump to declare a national emergency. On Wednesday, the president told Fox Business Network he would do so.

Officials told reporters on the conference call that Federal Emergency Management Agency funds that would have been released under a national emergency are already exhausted from recent storms that struck Puerto Rico, Texas and Florida.

The administration would have to work with Congress to help provide additional funding to address drug abuse, they added.

Under Thursday’s declaration, treatment would be made more accessible for abusers of prescription painkillers, heroin and fentanyl, while ensuring fewer delays in staffing the Department of Health and Human Services to help states grapple with the crisis.

‘BAD ACTORS’

Trump said he would discuss stopping the flow of fentanyl, a drug 50 to 100 times more powerful than morphine, with Chinese President Xi Jinping during his visit to Asia next month.

In his remarks, Trump said the U.S. Postal Service and Department of Homeland Security were “strengthening the inspection of packages coming into our country to hold back the flood of cheap and deadly fentanyl, a synthetic opioid manufactured in China.”

He added he would consider bringing lawsuits against “bad actors” in the epidemic. Several states have sued opioid manufacturers for deceptive marketing. Congress is investigating the business practices of manufacturers.

The president also said the government should focus on teaching young people not to take drugs. “There is nothing desirable about drugs. They’re bad,” he said.

Thursday’s declaration also allows the Department of Labor to issue grants to help dislocated workers affected by the crisis. HIV/AIDS health funding would also be prioritized for those who need substance abuse treatment, officials said.

As a candidate, Trump promised to address the crisis, including by building a wall on the U.S.-Mexico border to stop the flow of illicit drugs, which he touched on in his speech.

Additional actions under the move would be announced in coming weeks by various agencies, officials said.

(Additional reporting by James Oliphant, Susan Heavey and Jason Lange; Editing by Kevin Drawbaugh and Peter Cooney)

Rhode Island doctor pleads guilty to opioid kickback scheme related to Insys

FILE PHOTO: A box of the Fentanyl-based drug Subsys, made by Insys Therapeutics Inc, is seen in an undated photograph provided by the U.S. Attorney's Office for the Southern District of Alabama. U.S. Attorney's Office for the Southern District of Alabama/Handout via REUTERS

By Nate Raymond

BOSTON (Reuters) – A Rhode Island doctor pleaded guilty on Wednesday to charges he participated in a scheme to obtain kickbacks in exchange for writing prescriptions for an addictive fentanyl-based cancer pain drug produced by Insys Therapeutics Inc.

The plea by Jerrold Rosenberg came amid ongoing investigations of Insys related to Subsys, an under-the-tongue spray that contains fentanyl, a synthetic opioid.

Rosenberg, 63, pleaded guilty in federal court in Providence, Rhode Island, to charges that he committed healthcare fraud and conspired to receive kickbacks to prescribe Subsys.

Prosecutors said that from 2012 to 2015, Rosenberg schemed to receive $188,000 in kickbacks in the form of speaker fees from Insys, which were a major factor in his decision to prescribe Subsys to patients.

He also fraudulently indicated that his patients suffered from cancer pain when they did not in order to secure insurance approvals for Subsys, prosecutors said.

Under a plea agreement, Rosenberg agreed to pay $754,736 in restitution to healthcare benefit programs. He faces a maximum prison sentence of 15 years and is scheduled to be sentenced on Jan. 16.

Rosenberg’s lawyer did not respond to a request for comment. Chandler, Arizona-based Insys in a statement said it has “taken necessary and appropriate steps to prevent past mistakes from happening in the future.”

The investigations into Insys have come during a national epidemic of opioid abuse. According to the U.S. Centers for Disease Control and Prevention, opioids were involved in more than 33,000 deaths in 2015. The death rate has continued to rise, according to estimates.

In December, federal prosecutors in Boston charged six former Insys executives and managers, including ex-Chief Executive Michael Babich, with engaging in a scheme to bribe doctors to prescribe Subsys and defraud insurers.

All six have pleaded not guilty. Federal charges have also been filed in several other states against other ex-Insys employees and medical practitioners who prescribed Subsys.

Insys has been in settlement talks with the U.S. Justice Department. It said on Wednesday it is working “with relevant authorities to resolve issues related to the misdeeds of former employees.”

Insys also faces lawsuits by attorneys general in Arizona and New Jersey. It previously paid $9.45 million to resolve investigations by attorneys general in Oregon, New Hampshire, Illinois and Massachusetts.

The case is U.S. v. Rosenberg, U.S. District Court, District of Rhode Island, No. 17-cr-00009.

(Reporting by Nate Raymond in Boston; Editing by Matthew Lewis)