New Jersey is leading the nation’s fight against the opioid epidemic. Lawmakers fast-tracked and the governor signed historic legislation to help curb addiction. The U.S. Attorney’s added judicial clout by prosecuting one of the nations largest pharmaceutical distributors for turning a blind eye to suspicious oxy and hydrocodone orders. McKesson will pay $150 million dollars in penalties and halt sales of opiates at distribution centers in four states. U.S. Attorney Paul Fishman sat down with NJTV News Anchor Mary Alice Williams to discuss the matter.
Williams: What’s the significance of the McKesson case and what does $150 million mean to Big Pharma?
Fishman: I think it’s not just the money. There are three or four major wholesalers of controlled substances in the United States that distribute them to pharmacies all across the country. The DEA, the federal government, has imposed an obligation on those companies to make sure that they monitor what are called synthetic, what I were to call suspicious order reports. When they see pharmacies or chains of pharmacies ordering amounts of a substance that should raise eyebrows, they have an obligation to report that to the DEA and McKesson knew that. They have been sanctioned by the DEA for not doing it well enough in 2008 and over the course of time, they implemented a compliance program but just really didn’t follow it. As a result, they really weren’t honoring their legal obligations. And now my office and a bunch of U.S. attorney’s offices around the country has said that’s not OK and we’ve settled with McKesson for $150 million, imposed a whole new compliance regime and they will have a court appointed monitor for five years to make sure that they’re actually doing what they’re supposed to do.
Williams: Many prescription drug addictions begin with doctors’ prescriptions. Is the problem with the pharmas or the doctors?
Fishman: I don’t think you can blame only one set of folks. We have 5 percent of the world’s population. We prescribe 75 percent of the world’s painkillers. That’s a stunning statistic. One of the things we have to do is take a look at the way people are prescribing, we have to take a look at the information doctors have access to about whether patients have been somewhere else, we have to do better at having doctors pay attention to what their patients are doing after they see them, we have to do better education of people in medical school. I’ve been in, for the past three or four years, I’ve been out speaking to all of the hospital associations in New Jersey, to the New Jersey Hospital Association, I’ve done grand rounds at Rutgers to the medical school, I’ve spoken to all the doctors at Hackensack Hospital and Deborah Hospital, I’m supposed to go to Cooper and St. Joe’s in the next two months to basically give them the perspective of those of us in law enforcement that they can and should do more.
Williams: This new law that will limit prescriptions and expand treatment options for people who are addicted, would you call that more than a good start?
Fishman: Well, I think it’s a very important piece of the puzzle but there needs to be a lot of things that have to happen. One thing is enforcement, criminal enforcement, against doctors and pharmacists and others who are contributing to the problem. In my office we’ve prosecuted probably half a dozen doctors and half a dozen pharmacists, most recently the pharmacists who owned the Medford and Old Medford pharmacies in South Jersey for participating in schemes to illegally distribute Oxycontin and other painkillers. In addition, we have to be embarked on a real public education campaign. Starting in 2011 or 2012, my office hosted two summits bringing together educators, people in law enforcement, people in medicine to get together and talk about how we can do better collectively. We have to do better to explain this to parents and kids and of course the coaches, exactly. The piece that the Legislature and the governor enacted this week is an important part of the puzzle. The treatment that they’re going to do, having inpatient treatment, also really important. All of it has to work together to try to really put a stop to this terrible epidemic.
Williams: Let’s talk about Newark law enforcement. A federal monitor was brought in to oversee the police department after clear violations of civil rights were demonstrated over time. How is that going?
Fishman: So I think it’s going pretty well. We spent — my office and our colleagues at the Department of Justice in Washington, the civil rights division — spent three years taking a hard look at the Newark Police Department. What we found was partly what I knew to be true, which is that most of the men and women who put on the badge in Newark are cops that took those jobs for exactly the right reason, but over time some things have happened to the culture of the police department in some ways — part of it is training, part of it is resources. And so we agreed with the city, we signed a consent decree with the city last spring to bring real transformative change to the police department so the cops on the beat can do their jobs the way they want to and better.
Williams: What about community involvement?
Fishman: So, during the course of the investigation we were out in the community a lot soliciting community input on what the community perceived the problems to be. And part of it is the police and the community are not in touch with each other in a way that really will lead to real relationships that matter. And now that we have the monitor, part of the monitor’s charter is to go out and talk to people in the community, make sure that the community has input into the changes that are taking place and more important is available to the monitor to say some of the changes are working, some of them are not, here’s what we think should happen.
Williams: Newark has declared itself a sanctuary city, as have others around the state. Does that carry any legal weight and have you received any guidelines from the Trump administration about how to handle sanctuary cities in light of the immigration order?
Fishman: So, first of all it’s not clear that it’d be in the lane of the U.S. attorney’s office anyways. There’s been a long standing federal executive branch policy that cities are free to engage in a voluntary agreement with the federal government to decide if they want to embark on some law enforcement on behalf of the federal government. It’s been a voluntary program. So far there’s been no guidance that it’s going to go anywhere beyond that yet from the new administration.