Interprofessional collaboration is crucial to effectively curbing our state’s addiction to opioids and adequately addressing the impact of this crisis on our families. We not only urgently need more treatment facilities, we also must address neglected and orphaned children, education of our entire community, sentencing alternatives, and generally changing the approach in pain management. Opioids don’t pick their victims, so the greater number of diverse approaches we have to ending this epidemic the better.
Interdisciplinary work is not new to the Attorney General’s office. When Mike Moore served as Attorney General, I worked with him and a group of various professionals to review model drug laws for the state. This introduced me to the importance of working with mental health professionals and of focusing on prevention. Legal and scientific professionals can learn from each other, and both perspectives are critical to an all-inclusive approach to this type of problem.
Later, our office created model programs teaching students about domestic violence by using art, which is another example of an interdisciplinary approach. We also trained all types of professionals—hair dressers, teachers, and doctors—to recognize domestic violence. You can use the same approach for suicide prevention—we’re currently developing an app for youth that allows them to recognize the various causes of suicidal thoughts and provides an outlet that may be more comfortable than going to a counselor in person.
This same interprofessional approach can and should be used in our response to the opioid crisis. This is not a “one size fits all” problem, nor does it need that type of solution. Our office is tackling the opioid crisis in a number of ways, including litigation.
The practice of big corporations making false representations to consumers or failing to protect consumers is unfortunately not new, and the Mississippi Attorney General’s Office and our fellow enforcers have a history of holding them accountable. In 2011, tech giant Google entered a Non-Prosecution Agreement with the Department of Justice after authorities alleged that Google knowingly allowed Canadian pharmacies to illegally market prescription and counterfeit drugs in the United States. The agreement required Google to forfeit $500,000,000, which was the estimated amount of income Google earned from these illegal advertisements.
The agreement further required a two-year probationary period where the DOJ would continue to monitor Google’s activity related to the charges and the company’s remediation actions. Essentially, Google was placed on probation. During the probationary period, our own investigators went online and successfully purchased illegal drugs, including opioids, that were continuing to be advertised through Google. These buys were part of the investigation that my office conducted regarding Google’s business practices.
Those actions were just one step in combatting the illicit drug market, but the opioid crisis started long before that, from what we believe is largely due to conduct by the opioid manufacturers. Our office was the first in the country to sue multiple opioid manufacturers on behalf of a state. We argue that these companies misled consumers about the dangerous effect of opioids by marketing the drug as rarely addictive. It’s our belief these manufacturers (16 in the suit) deceived Mississippi Medicaid, doctors, and consumers in order to boost profits at the expense of innocent victims. That lawsuit was filed in Hinds County in December 2015 and is currently pending.
This fall, our office launched an awareness campaign on the dangers of e-cigarette use. Although these devices help some people stop smoking traditional cigarettes, we are seeing our teenagers start with vaping and get addicted to the nicotine that is packed in each pod. Unfortunately, there are no regulations on these products, so mom-and-pop shops are able to mix their own liquid nicotine to go in the e-cigarette, which opens the door to the mixing of illegal chemicals.
Just this summer, the Mississippi Bureau of Narcotics found the deadly opioid fentanyl mixed into a nicotine pod at a shop here in our state. That is why our state needs to find a way to require that any product shipped to a vape shop remains sealed prior to the sale, and I plan on asking the Legislature to consider this in the upcoming session as one more way to stop opioid abuse and prevent unintentional consumption of deadly drugs.
Our office has been a part of the Mississippi Opioid and Heroin Drug Summit since its inception two summers ago. This summit is a great example of partnering with non-governmental stakeholders in this fight. In order to successfully address the opioid epidemic, it will take not only government intervention, but also partnerships between the public and private sector. It is imperative that treatment be evidence-based and tailored to the best approach for each patient to overcome their particular substance abuse disorder.
Finally, I have pushed for the development of new prescribing rules for health care professionals that would curb patients’ abilities to prolong unnecessary opioid prescriptions. These rules, which would not take away prescriptions for patients who truly need it—such as those who have terminal disease pain or are in hospice care–went into effect last month by the Board of Medical Licensure and the Board of Pharmacy. The Board of Nursing rules are in the approval process. The new rules are intended to stop the overprescribing of long-acting opioids for those who have acute non-cancer or non-terminal pain.
The rules distinguish between chronic, acute, and terminal disease pains, and they incorporate the Mississippi Prescription Monitoring Program (MPMP). I understand that some people truly depend on opioids to deal with pain that is life altering. However, it is our responsibility to make sure our prescribing practices do not continue allowing patients, who have alternative pain management options, to have a prescription so vast that it leads to addiction or death.
» Jim Hood is the Attorney General for the State of Mississippi.
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