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scotus-tears-down-sacklers’-immunity,-blowing-up-opioid-settlement

SCOTUS tears down Sacklers’ immunity, blowing up opioid settlement

Not immune —

Majority of justices ruled on meaning of legal code; dissenters called it “ruinous”

Grace Bisch holds a picture of stepson Eddie Bisch who died as a result of an overdose on outside of the U.S. Supreme Court on December 4, 2023  in Washington, DC. The Supreme Court heard arguments regarding a nationwide settlement with Purdue Pharma, the manufacturer of OxyContin.

Enlarge / Grace Bisch holds a picture of stepson Eddie Bisch who died as a result of an overdose on outside of the U.S. Supreme Court on December 4, 2023 in Washington, DC. The Supreme Court heard arguments regarding a nationwide settlement with Purdue Pharma, the manufacturer of OxyContin.

In a 5-4 ruling, the US Supreme Court on Thursday rejected an opioid settlement plan worth billions over the deal’s stipulation that the billionaire Sackler family would get lifetime immunity from further opioid-related litigation.

While the ruling may offer long-sought schadenfreude over the deeply despised Sackler family, it is a heavy blow to the over 100,000 people affected by opioid epidemic who could have seen compensation from the deal. With the high court’s ruling, the settlement talks will have to begin again, with the outcome and possible payouts to plaintiffs uncertain.

Between 1999 and 2019, as nearly 250,000 Americans died from prescription opioid overdoses, members of the Sackler family siphoned approximately $11 billion from the pharmaceutical company they ran, Purdue Pharma, maker of OxyContin, a highly addictive and falsely marketed pain medication. In 2007, amid the nationwide epidemic of opioid addiction and overdoses, Purdue affiliates pleaded guilty in federal court to falsely branding OxyContin as less addictive and less abusive than other pain medications. Out of fear of future litigation, the Sacklers began a “milking program,” the high court noted, draining Purdue of roughly 75 percent of its assets.

An “appropriate” deal

In 2019, Purdue filed for Chapter 11 bankruptcy, leading to negotiations for a massive consolidated settlement plan that took years. As part of the resulting deal, the Sacklers—who did not file for bankruptcy and had detached themselves from the company—agreed to return up to $6 billion to Purdue, but only in exchange for immunity. The bankruptcy court approved the controversial condition, while a district court later overturned it and a yet higher court reinstated it.

In today’s majority opinion from the Supreme Court, Justices Gorsuch, Thomas, Alito, Barrett, and Jackson found that the lower courts that approved the Sackers’ immunity condition had erred in interpreting Chapter 11 bankruptcy code. “No provision of the code authorizes that kind of relief,” they court ruled. The explanation boiled down to a single sentence in a catchall provision. While the code speaks solely about responsibilities of a debtors—which in this case is Purdue, not the Sacklers—the catchall provision allows “for any other appropriate provision” not otherwise outlined.

The erring lower courts, the high court wrote, had interpreted the word “appropriate” far too broadly. Based on the context, any additional “appropriate” arrangements in a settlement that was not explicitly outlined would apply only to the debtor (in this case, Purdue) not to nondebtors (the Sacklers). The provision cannot be read, the justices wrote, “to endow a bankruptcy court with the ‘radically different’ power to discharge the debts of a nondebtor.”

“Ruinous” ruling

Justices Kavanaugh, Sotomayor, Kagan, and Roberts disagreed. In a minority opinion penned by Kavanaugh and joined by Sotomayor and Kagan, the justices blasted the ruling, calling it “wrong on the law and devastating for more than 100,000 opioid victims and their families.”

“The text of the Bankruptcy Code does not come close to requiring such a ruinous result,” Kavanaugh wrote, noting that such deals granting immunity to “nondebtors” is a longstanding practice used to secure just settlements. Neither legal structure, context, nor history necessitate today’s ruling, Kavanaugh continued. “Nor does hostility to the Sacklers—no matter how deep: ‘Nothing is more antithetical to the purpose of bankruptcy than destroying estate value to punish someone,” he wrote, citing a legal essay on Chapter 11 for mass torts.

The opioid victims and others will “suffer greatly in the wake of today’s unfortunate and destabilizing decision,” the dissenting justices wrote. “Only Congress can fix the chaos that will now ensue. The Court’s decision will lead to too much harm for too many people for Congress to sit by idly without at least carefully studying the issue.”

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Huge telehealth fraud indictment may wreak havoc for Adderall users, CDC warns

Tragic —

The consequences are dangerous, possibly even deadly, for patients across the US.

Ten milligram tablets of the hyperactivity drug, Adderall, made by Shire Plc, is shown in a Cambridge, Massachusetts pharmacy Thursday, January 19, 2006.

Enlarge / Ten milligram tablets of the hyperactivity drug, Adderall, made by Shire Plc, is shown in a Cambridge, Massachusetts pharmacy Thursday, January 19, 2006.

The Centers for Disease Control and Prevention on Thursday warned that a federal indictment of an allegedly fraudulent telehealth company may lead to a massive, nationwide disruption in access to ADHD medications—namely Adderall, but also other stimulants—and could possibly increase the risk of injuries and overdoses.

“A disruption involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 US states,” the CDC wrote in its health alert.

The CDC warning came on the heels of an announcement from the Justice Department Thursday that federal agents had arrested two people in connection with an alleged scheme to illegally distribute Adderall and other stimulants through a subscription-based online telehealth company called Done Global.  The company’s CEO and founder, Ruthia He, was arrested in Los Angeles, and its clinical president, David Brody, was arrested in San Rafael, California.

“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” Attorney General Merrick Garland said in a statement. “Those seeking to profit from addiction by illegally distributing controlled substances over the Internet should know that they cannot hide their crimes and that the Justice Department will hold them accountable.”

Deadly consequences

According to the Justice Department, Done Global generated $100 million in revenue by arranging for the prescription of over 40 million pills of Adderall and other stimulants, which are addictive medications used to treat ADHD (attention-deficit/hyperactivity disorder). Done Global allegedly eased access to the drugs by limiting the information available to prescribers, instructing prescribers to prescribe Adderall and other stimulants even if the patient didn’t qualify, and mandating that the prescribing appointments last no longer than 30 minutes. The company also discouraged prescriber follow-up appointments and added an “auto-refill” feature.

Prosecutors further allege that He and Brody continued with their scheme after becoming aware that patients had overdosed and died.

The CDC cautioned that the disruption from lost access to Done Global prescriptions comes amid a long-standing, nationwide shortage of Adderall and other stimulant medications. For patients with ADHD, the disruption could be harmful. “Untreated ADHD is associated with adverse outcomes, including social and emotional impairment, increased risk of drug or alcohol use disorder, unintentional injuries, such as motor vehicle crashes, and suicide,” the CDC warns. Further, a loss of access could drive some to seek illicit sources of the drugs, which could turn deadly.

“Patients whose care or access to prescription stimulant medications is disrupted, and who seek medication outside of the regulated healthcare system, might significantly increase their risk of overdose due to the prevalence of counterfeit pills in the illegal drug market that could contain unexpected substances, including fentanyl,” the CDC said. Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.

The Drug Enforcement Administration recently reported that seven out of every 10 pills seized from the illegal drug market contain a potentially lethal dose of illegally made fentanyl, the CDC noted.

This post was updated to clarify that the DEA’s data indicated that 70 percent of illicit pills seized contained “potentially” lethal doses, which was not included in the CDC’s warning.

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