Overnight Health Care: Watchdog finds DEA allowed more opioids even as overdose deaths rose | Judge temporarily blocks Georgia abortion law | Three states report more vaping deaths | Dem proposes new fix for surprise medical bills

Welcome to Tuesday’s Overnight Health Care.

A Justice Department watchdog issued a scathing report of the Drug Enforcement Administration’s handling of the opioid crisis. Democrats on the Ways and Means Committee are out with a new surprise billing proposal, and three more states are reporting vaping-related deaths. 

We’ll start with news on opioids…

 

Watchdog: DEA allowed increase of opioid production as overdose deaths rose 

The Drug Enforcement Administration (DEA) allowed drugmakers to increase production of opioids even as overdose deaths were skyrocketing, according to a government watchdog’s scathing report released Tuesday.

While opioid overdose deaths grew by 8 percent per year from 1999 through 2013, and by 71 percent per year between 2013 and 2017, the DEA authorized manufacturers to produce “substantially larger amounts of opioids,” reads the report from the Justice Department’s Office of the Inspector General. 

{mosads}The DEA was “slow” to address the opioid epidemic and did not substantially reduce the number of pills drug makers were permitted to make until 2017, the same year overdose deaths hit a record high, the report says.

“We found that DEA was slow to respond to this growing public health crisis and that its regulatory and enforcement efforts could have been more effective,” Inspector General Michael Horowitz said in a video statement. 

The DEA, which is charged with keeping controlled substances from being diverted for abuse, had already been criticized by advocates for not using its powers to curb the opioid epidemic.

The report also found that the DEA did not conduct background checks on doctors, dentists and pharmacists applying to handle controlled substances.

The report notes that the DEA doesn’t have a comprehensive national strategy for dealing with the opioid epidemic, although it has had such plans for past drug crises. 

The DEA’s response: In a statement Tuesday, the DEA said it “appreciates” the assessment, and that is has reduced the quota for the seven most frequently diverted opioids for the last three years.

It also said only a “minute fraction” of the more than 1.8 million manufacturers, distributors, pharmacies and prescribers registered with DEA are involved in unlawful activity, and it “continuously works to identify and root out the bad actors.”

Read more on the troubling report here.

 

Three states report more vaping deaths 

Nebraska, Virginia and New Jersey are reporting three vaping-related deaths, bringing the number of confirmed fatalities to 16. 

State health officials in Nebraska announced the death of a 65-year-old man Monday, but he died in May. 

Federal and state health officials are looking back in their investigations to find out how many people have died from the vaping-related illness. 

The illnesses have caught health officials by surprise, with the first cases being reported early this summer. 

A Virginia resident died Sept. 26 at a hospital in North Carolina, but health officials did not release more details.  

“I am deeply saddened to announce the first death of a Virginia resident related to this outbreak,” State Health Commissioner M. Norman Oliver said. “Our thoughts are with the family during this difficult time.”

New Jersey health officials announced Tuesday that a woman died from a vaping-related illness in August. 

The Centers for Disease Control and Prevention (CDC) said 13 people had died nationally as of last week. The CDC typically updates its numbers on Fridays.

More on the vaping deaths here.

 

Meanwhile, senators are pressing Juul’s new CEO about the company’s marketing and its relationship with Altria 

Senate Democrats on Tuesday sent a letter to K.C. Crosthwaite, the new CEO of Juul, pressing him about the company’s marketing tactics, they efforts Juul is taking to ensure its products aren’t being tampered with in order to vape illicit substances, and the company’s plans to adhere to the Food and Drug Administration’s (FDA) regulations of their products. 

Crosthwaite, a former Altria executive, took over Juul last week when former CEO Kevin Burns stepped down. The company, and the e-cigarette industry in general, has been facing intense scrutiny from federal and state officials.

While health officials said more than 70 percent of vaping deaths have been from people who used THC, the issue has also collided with a massive spike in teen vaping. 

Senators are concerned about how Juul and other e-cigarette companies have contributed to that spike. 

The letter was led by the No. 2 Senate Democrat Dick Durbin (Ill.), and signed by eight other lawmakers. 

“Every single one of our federal public health agencies has declared youth vaping an ‘epidemic’–an epidemic that JUUL, more than any other company, has fueled.  As the new CEO of JUUL, you are now responsible for what happens next. It is our hope that you choose to protect children over profits,” the senators wrote. 

Juul has repeatedly insisted it did not deliberately target children with its advertising, and has supported efforts to raise to 21 the legal age to buy tobacco. When Burns stepped down, Juul also said it would stop all advertising in the U.S.

The lawmakers also sent a separate letter to Altria’s chairman Howard Willard, asking for details about the public health impact of Altria’s purchase of a 35 percent stake in Juul. 

 

Dem chairman proposes new fix for surprise medical bills

We’ve got some fresh news on the battle over surprise medical billing legislation.

In a letter to Democratic lawmakers obtained by The Hill, House Ways and Means Committee Chairman Richard Neal (D-Mass.) is proposing a new solution that would essentially punt the details of the fix to a committee consisting of stakeholder groups and the Departments of Health and Human Services, Labor, and Treasury. The committee would come up with recommendations that would then be issued in a regulation from the administration. 

The politics: Neal’s move could get around the intense lobbying from doctors and hospitals, who don’t like the leading proposal from the House Energy and Commerce Committee and Senate Health Committee. But also, it might not. No groups have supported the Neal approach yet either.  

Read more here 

 

Federal judge temporarily blocks Georgia abortion law

A federal judge on Tuesday temporarily blocked a Georgia abortion law that would ban the procedure once a fetal heartbeat is detected, which generally occurs in the first six weeks of a pregnancy.

The ruling follows a series of similar court decisions to block restrictive abortion laws from going into effect in several other states. Georgia’s law had been slated for enforcement starting Jan. 1.

Republican lawmakers have said they deliberately wrote the laws to be challenged in court. The ultimate goal is to bring a challenge before the conservative-majority Supreme Court, to have a chance at overturning the landmark abortion ruling in Roe v. Wade.

More on Georgia here.

 

What we’re reading

The FDA tried to ban flavors years before the vaping outbreak. Top Obama officials rejected the plan (Los Angeles Times)

‘We’re trying to protect children’: Donna Shalala on e-cigarettes (Roll Call)

Juul hires ‘political dark arts’ firm led by ex-Clinton campaign director in its fight for survival (CNBC)

 

State by state

Ohio Gov. Dewine wants lawmakers to ban sales of flavored vaping products (Columbus Dispatch)

Health insurance rates through Affordable Care Act drop for first time in Delaware (Delaware Online)

Utah submits ‘fallback’ Medicaid waiver for public comment (Deseret News)

These Alabama sheriffs release sick inmates to avoid paying their hospital bills (ProPublica)