A July of 2022 court settlement surrounding the prescription opioid drug crisis has put an inadvertent bureaucratic taper on supply to the burgeoning market for softer prescription drugs, such as Xanax and Adderall.
Supply tapers are particularly sensitive following a late 2022 supply chain shortage that appears to have been created by increased demand following a boom in telehealth prescriptions during the Coronavirus Disease 2019 (COVID-19) pandemic lockdowns.
An April 3 article by Bloomberg referencing on-the-ground reporting from pharmacists who complained they have become unable to order supply to fill prescriptions somewhat vaguely explained, “One major settlement required the three largest distributors to set thresholds on orders of controlled substances starting last July.”
A landmark
The suits in question appear to refer to a massive $26 billion settlement among Big Pharma cornerstones such as Johnson & Johnson. February of 2022 reporting on the settlement by The New York Times said that 85 percent of the money would be devoted to “addiction treatment and prevention services.”
MORE ON THE RAGING DRUG EPIDEMIC
- British Columbia Opioid Deaths Outpace COVID Fatalities Amid China-linked Drug Epidemic
- Were Chinese Nationals Behind the Mid-2022 Cold Medication and Pain Killer Shortages?
- California DA Charges Fentanyl Traffickers With Manslaughter After 800% Increase In Overdose Deaths
- US Authorities Bust Major Drug Operation in Oregon Linked to Chinese Triad
“By signing onto the deal, thousands of local governments as well as states have agreed to drop their opioid lawsuits against the companies and also pledge not to bring any future action,” NYT explained.
Success
You are now signed up for our newsletter
Success
Check your email to complete sign up
This settlement was such a landmark that the Times described it as “second only to the Big Tobacco settlement of the late 1990s as a multistate agreement.”
A key feature of the resolution of the multi-year case beyond the enormous financial penalties was explained in the following way, “A major theme coursing throughout the opioid litigation has been the aggressive marketing of the drugs, which went all but unchecked for years.”
“Distributors almost never sent up warning flares when pharmacy clients took deliveries of quantities of opioids that were wildly disproportionate to the local population,” authors added.
The Times added that distributors, as part of their role in the settlement, “Must set up an independent clearinghouse to track and report one another’s shipments” for the purpose of raising “red flags immediately when outsize orders are made.”
Pharmacists told Bloomberg the result is that once their locations have “exceeded its limit for a specific drug over a certain time period,” orders become marked as “suspicious orders” and will not be fulfilled.
Indie pharmacies were paraphrased as lamenting that they have resorted to sending patients “on frustrating journeys to find pharmacies that haven’t yet exceeded their caps in order to buy prescribed medicines.”
Spokespersons for both CVS and Walgreens were either unwilling to comment or replied only with boilerplate messaging when probed by Bloomberg on the topic.
Bloomberg also states that the suit bars drug wholesalers from telling pharmacies “what the thresholds are, how they’re determined or when the pharmacy is getting close to hitting them.”
The purpose of the clause in the settlement was described by experts the outlet interviewed as being to prevent pharmacies and pharmacists from gaming the system.
Where there’s a will
However, the actual problem with supply chokeholds may result from as much the demand side of the economy as the supply side of the economy.
In September of 2022, reports abounded about how users of the ADHD drug Adderall, an amphetamine, were struggling to find pharmacies who could fulfill their orders, leading to users who had become reliant on the chemical to suffer from withdrawal symptoms.
But one core issue to the development was that prescriptions for Adderall had sharply increased during the COVID-19 stay-at-home and do-everything-over-Zoom changes to the human living condition mandated by virtually all levels of government and corporations.
In 2021 alone, prescriptions for the drug increased to over 41 million from 37 million the year prior.
In an October of 2021 notice by the Drug Enforcement Administration (DEA) on annual drug production quotas, the agency noted the problem, “While DEA has observed a significant increase in demand among domestic manufacturers to bring generic ADHD-products to a relatively stable domestic market, it has also grown increasingly concerned over how these market forces may impact the misuse of prescription stimulants among young adults.”
A March 31 notice issued by the CDC on the topic said, “Prescriptions for stimulants, primarily used to treat attention-deficit/hyperactivity disorder (ADHD), were increasing for adults before the COVID-19 pandemic.”
The CDC added, “Policies enacted during the pandemic expanded access to prescription stimulants via telehealth.”
While the overall ratio of people subscribed under employer-sponsored health plans “with one or more prescription stimulant fills” increased tolerably from 3.6 percent in 2016 to 4.1 percent in 2021, the CDC cautioned that the increase is particularly dense in younger demographics.
“The percentages of females aged 15–44 years and males aged 25–44 years with prescription stimulant fills increased by more than 10% during 2020–2021,” the alert said.
A March 14 article by The Washington Post on the Adderall shortage patently stated, “An explosion of telemedicine during the pandemic has contributed to a surge in Adderall prescriptions, helping to set the stage for a shortage that has dragged on for months.”
In February, the DEA issued a Proposed Rule to require that telehealth prescriptions for certain drugs, such as Adderall, can only be issued after the physician and the patient have met in person.
Bad for business
Bloomberg’s April article interviewed an independent New York pharmacist who specifically cited his frustration with being unable to order “all attention-deficit/hyperactivity disorder medications including Concerta and Ritalin.”
The article said that while “supply chain issues had already created scarcity of the drugs,” today, the pharmacist is unable to order them even when they’re available because of the arcane limitations set by the settlement.
The constraints are so severe that in February, from one specific distributor, his business only received 100 pills compared to the 3,700 delivered the month prior.
By the 23rd of March, no further shipments had been processed.
One pharmacist located in Salt Lake City told Bloomberg that his business stopped receiving any shipments after it ordered so many “fentanyl lozenges” that a review was triggered.
When requesting comment from the wholesalers on the topic, one lamented having “been asked to walk a legal and ethical tightrope” in the drug distribution business.
To get around the issue, one indie pharmacist in Seattle told Bloomberg that he had resorted to buying small quantities of double-strength pills and cutting them in half, or coordinating with physicians to schedule prescription refills to come due after the limits were likely to reset.
Despite the restrictions on the legal market for regulated drugs, America’s porous Southern Border brought on by the long-standing migrant crisis has resulted in an epidemic of dangerous drugs like fentanyl being imported by Mexican drug cartels, who obtain precursor chemicals from Chinese Communist Party-linked firms located in mainland China, and then traffic them into America.
Just one seizure of “rainbow fentanyl” at the border between Nogales, Mexico and Arizona resulted in a haul of 625,000 pills for the U.S. Customs and Border Patrol agency in August of 2022.
34 pounds of methamphetamine and 5 pounds of marijuana were also seized in the operation.
