Joseph T. Rannazzisi leaves no one out when he’s assigning blame for the opioid epidemic.
“We would never be where we are today if the industry was doing their job,” said Rannazzisi, a former federal Drug Enforcement Administration (DEA) official who’s bringing his message to Minnesota as he prepares to testify on state legislation aimed at curbing the epidemic. “I’m talking about everybody: the doctors, the pharmacists, distributors, the manufacturers.”
Few know more about the causes of the opioid epidemic than this former deputy assistant administrator of the DEA, or have seen the influence of an industry he says helped fuel the crisis. Opioid abuse killed nearly 400 Minnesotans and 53,000 Americans in 2016.
Rannazzisi was a whistleblower in a “60 Minutes”-Washington Post investigation last year. The report detailed how the drug industry used its influence in Congress and in the executive branch to take away the DEA’s most potent tool for stopping drug companies suspected of allowing drugs to wind up in the wrong hands. And, he said, they used their allies in government to end his 29-year law enforcement career because he was a tough cop who knew his business.
On Thursday, Rannazzisi is scheduled to testify for a proposal to tax prescription opioids a penny on each milligram of active ingredient in a pain pill. The proceeds, estimated to be about $20 million per year, would go toward prevention, emergency response, treatment and recovery and law enforcement.
“The state should not bear the burden of doing treatment while corporations make a lot of money because of the way they’ve marketed or sold their drugs,” he said.
Despite bipartisan advocacy from two lawmakers who lost children to the epidemic, as well as support from Gov. Mark Dayton, the bill faces an uncertain path at the State Capitol.
Anti-tax advocate Grover Norquist has warned Republican lawmakers that supporting such a tax would betray the party’s most firmly held principal of holding the line against any tax increases.
Nick McGee, director of public affairs for PhRMA, an influential industry lobbying group, said the tax “indiscriminately taxes prescribed medications that patients legitimately rely on for serious, debilitating and sometimes fatal conditions.”
McGee said the industry wants a comprehensive solution that includes a limit on the supply of opioids for acute pain to seven days, with clear exceptions; prescriber training to ensure treatment of addiction and pain; elimination of coverage barriers that keep patients from accessing all forms of addiction treatment, including medication; and recovery support.
“Putting an end to the epidemic will require a new level of collaboration among supply chain stakeholders, law enforcement — notably DEA — and the broader health care community,” said John Parker, spokesman for the Healthcare Distribution Alliance.
Rannizzisi has little use for industry claims, especially when companies told doctors the drugs were safe: “I went to pharmacy school in the late ’70s and early ’80s. The message was clear: opioids, when used in an unsupervised manner, become very addictive and very dangerous,” he said. “How could they say the potential for addiction was not what they thought. It’s mind-boggling.”
He started seeing opioids on the internet around 2004 — easy access to pills, without seeing a doctor. Once the regulators got wise to it, the “pain clinics” began opening everywhere, and everyone in the supply chain was raking in the cash.
In one of his cases, Rannizzisi found 34 pharmacies had prescribed 98 million opioid pills.
What was once a pill problem has morphed into a pill and heroin problem, which Rannazzisi said he predicted.
“This is what angered a lot of people in government. We started saying, ‘We’re going to have a heroin problem. It’s just a matter of time,’ ” he said.
“People said, ‘You can’t say that. It’s not based in evidence,’ ” he said. “I said, ‘Besides all the people who are dying?’ ”
Rannazzisi is now a consultant to lawyers representing states and local governments in a massive lawsuit against the drug industry, modeled after the tobacco litigation of the 1990s.
For those who believe the opioid epidemic is someone else’s problem, or will exhaust itself, he has a message: “The opioid crisis is not just in someone else’s backyard. It’s in everyone’s backyard. The is problem isn’t going anyway anytime soon, and if we don’t become extremely aggressive, it’s going to continue.”