CENTER FOR ETHICS AND THE RULE OF LAW​

Legal Responses to the Opioid Addiction Crisis

Criminal, Civil, and Regulatory Solutions

March 16 -
 16, 2018

Co-sponsored By:

Center for Ethics and the Rule of Law – University of Pennsylvania (CERL, Penn))
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The Conference

This conference will consist of two parts. The morning session is by invitation only. The afternoon session, comprised of three panels and keynote speakers, is open to the public. We welcome your registration for the afternoon portion of the event by RSVP – see below.

The Opioid Addiction Crisis has caused approximately 633,000 deaths since 1999, more than ten times the total loss of U.S. life from the Vietnam War. On March 16, The Center for Ethics and Rule of Law (CERL) will host a public conversation designed to identify criminal, civil and regulatory solutions to address this crisis and to prevent a reoccurrence of this kind of public health emergency. Presenters draw from the ranks of health care professionals, lawyers, legislators, psychologists, and scholars from a variety of disciplines to discuss recent developments in the opioid epidemic as well as proposals for legal action and policy reform. What is the liability of pharmaceutical companies in relation to advice they gave to doctors that pain was being “undertreated”? Are civil suits that are currently being filed against pharmaceutical companies on behalf of a number of American cities likely to succeed?  Are federal agencies, particularly the FDA, the Veterans Administration (VA) and possibly the CDC responsible for failing to protect veterans and other vulnerable consumers from the perils of addiction?  What regulatory reforms need to be adopted to ensure this never occurs again?

Prescribing opioids for physical pain to vulnerable populations suffering from a high degree of psychological distress has been a recipe for addiction. Unfortunately, the misleading marketing practices of some drug companies has contributed greatly to this problem. Despite recognition from the Center for Disease Control (CDC) that we are lacking critical evidence about the safety and effectiveness of treating pain with opioids, the rate of opioid prescription for veterans as well as for the general population has increased exponentially over the past decade.

Many have begun to question the ethical and legal ramifications of persistent opioid prescription within the last few years.  How are the current laws and regulations addressing the crisis? Are they adequate, or do we need additional policies and legal solutions to help curb the widespread abuse? What are the implications of the “War on Drugs” on the opioid epidemic? State and local law enforcement have been in the vanguard of addressing this crisis, but many feel that the efforts of responsible agencies in the federal government lags behind.  Are state and local efforts being adequately supported by the federal government?  What kind of regulation is needed at both levels of government at this late stage in the crisis?  What measures should be taken to avoid a public health crisis of this dimension in the future? 

The Center for Ethics and Rule of Law (CERL) will host this high-level, one-day event to focus on possibilities for civil, criminal, and regulatory solutions to stem the morbidities and death from the crisis. We will draw from the ranks of health care professionals, lawyers, legislators, psychologists, and scholars from a variety of disciplines to discuss recent developments as well as the implications for legal and policy reform. Participants will address questions that affect each of their professional communities in different, but interrelated ways. What is the liability of pharmaceutical companies in relation to doctors? Are federal agencies, particularly the FDA, the Veterans Administration (VA) and possibly the CDC responsible for failing to protect veterans and other vulnerable consumers from the perils of addiction? 

This conference is timely, since both the cities of Philadelphia and New York have recently filed suits against various pharmaceutical companies for their role in the epidemic. But such civil litigation suits are only one possible solution. There is also attention currently on both the problems of opioid addiction and the mental health crisis in the veteran community. In Pennsylvania it has become a top priority of Governor Tom Wolf’s Administration. 

Following the conference, CERL will produce one or more briefing papers to address legal and regulatory solutions to the crisis along a number of domains – criminal prosecutions, civil suits and increased regulatory oversight and management.

This program has been approved for 4.0 ethics CLE credits for Pennsylvania lawyers. CLE credit may be available in other jurisdictions as well. Attendees seeking CLE credit should bring separate payment in the amount of $160.00 ($80.00 public interest/non-profit attorneys) cash or check made payable to The Trustees of the University of Pennsylvania.

This event is co-sponsored by the Sheller Family Foundation, the National Attorneys General Training & Research Institute, and Captain Robert G. Fuller., Jr, Esq.,  JAGC, USNR (Ret)

Press Release

Schedule

1:00 – 1:15pmOpening Remarks
 Dean Theodore RugerDean and Bernard G. Segal Professor of Law, University of Pennsylvania Law SchoolClaire Finkelstein, Co-founder and Faculty Director, CERL; Algernon Biddle Professor of Law and Professor of Philosophy, University of Pennsylvania  Sandy Sheller, President & Director, Sheller Family Foundation
1:15 – 2:45pmPanel 1: Criminal Law Solutions
 ModeratorProfessor Claire Finkelstein, Algernon Biddle Professor of Law and Professor of Philosophy; Faculty Director, CERLPanelists:Attorney General Matthew Denn, Attorney General of DelawareAttorney General Chris Carr, Attorney General of GeorgiaMs. Bridget Brennan, Special Narcotics Prosecutor, City of New YorkJudge Patrick Dugan, Chief Judge, Philadelphia Veterans Court.Dr. Steve Xenakis, Brigadier General (ret), Army Medical Corps
 2:45 – 3:00pmBreak
 3:00 – 4:15pmPanel 2: Corporate Responsibility and Civil Law Solutions
 Moderator:  Mr. Chris Naughton, American Law JournalPanelists:Mr. Don Migliori, Attorney, Motley RiceMs. Gerianne DiPianoPresident & CEO, FemmePharmaMr. Stephen Sheller, Founding Partner, Sheller P.C. Law FirmDr. Andrew Kolodny, Co-Director of the Opioid Policy Research Collaborative, Brandeis UniversityDr. Thomas Farley, Health Commissioner, City of Philadelphia
 4:15 – 4:30pmBreak
 4:30 – 6:00pmPanel 3: Regulatory Solutions
 Moderator: Mr. Chris Mondics, Legal Affairs Journalist, formerly of The Philadelphia Inquirer PanelistsDr. Steve Daviss,Senior Medical Advisor, Office of the Chief Medical Officer and Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA)Dr. Steve Peskin, Chief Medical Officer, Horizon Blue Cross Blue Shield of New JerseyMs. Maria D.Quinonas-Sanchez City Councilwoman, Seventh District, City of PhiladelphiaMs. Roseann Termini, Widener University School of LawDr. Jennifer Prah Ruger, Professor of Medical Ethics & Health Policy,  Perelman School of Medicine, University Of Pennsylvania
 6:00 – 7:30pm       Cocktail Party  – Haaga Lounge (The Goat)

Working Group Session

SILVERMAN CLASSROOM 245A
2ND FLOOR OF SILVERMAN BUILDING AT PENN LAW

By Invitation Only

This meeting will be conducted under
CHATHAM HOUSE RULE

8:00 – 9:00amContinental Breakfast
PENN LAW – Levy Conference Center
9:00 – 9:15amIntroductory Remarks – Professor Claire Finkelstein
9:15 – 10:00amMap Of The Crisis – Moderator: Mr. Greg Heller
10:00 – 10:45amHow Did We Get Here? – Moderator: Dr. Stephen N. Xenakis
10:45 – 11:00amBreak
11:00- 11:45amWhere Do We Go From Here? – Moderator: Mr. Benjamin Field and Vanessa Garret-Harley
11:45am – 12:45pmLunch for all Closed Door Participants and Panelists
PENN LAW – Levy Conference Center

Keynotes


March 16, 2018

Legal Responses to the Opioid Addiction Crisis: Criminal, Civil and Regulatory Solutions

Michael A. Fitts Auditorium, Golkin Hall 100
University of Pennsylvania Law School
3501 Sansom Street
Philadelphia, PA 19104

This event is open to the public and free of charge

The Opioid Addiction Crisis has caused approximately 633,000 deaths since 1999, more than ten times the total loss of U.S. life from the Vietnam War. On March 16, The Center for Ethics and Rule of Law (CERL) will host a public conversation designed to identify criminal, civil and regulatory solutions to address this crisis and to prevent a reoccurrence of this kind of public health emergency.

Presenters draw from the ranks of health care professionals, lawyers, legislators, psychologists, and scholars from a variety of disciplines to discuss recent developments in the opioid epidemic as well as proposals for legal action and policy reform. What is the liability of pharmaceutical companies in relation to advice they gave to doctors that pain was being “undertreated”? Are civil suits that are currently being filed against pharmaceutical companies on behalf of a number of American cities likely to succeed? 

Are federal agencies, particularly the FDA, the Veterans Administration (VA) and possibly the CDC responsible for failing to protect veterans and other vulnerable consumers from the perils of addiction?  What regulatory reforms need to be adopted to ensure this never occurs again?

Many have begun to question the ethical and legal ramifications of persistent opioid prescription within the last few years.  How are the current laws and regulations addressing the crisis? Are they adequate, or do we need additional policies and legal solutions to help curb the widespread abuse? State and local law enforcement have been in the vanguard of addressing this crisis, but many feel that the efforts of responsible agencies in the federal government lags behind.  Are state and local efforts being adequately supported by the federal government?  What kind of regulation is needed at both levels of government at this late stage in the crisis?  What measures should be taken to avoid a public health crisis of this dimension in the future? 

The Center for Ethics and Rule of Law (CERL) will host this high-level, one-day event to focus on possibilities for civil, criminal, and regulatory solutions to stem the morbidities and death from the crisis. We will draw from the ranks of health care professionals, lawyers, legislators, psychologists, and scholars from a variety of disciplines to discuss recent developments as well as the implications for legal and policy reform. Participants will address questions that affect each of their professional communities in different, but interrelated ways. What is the liability of pharmaceutical companies in relation to doctors? Are federal agencies, particularly the FDA, the Veterans Administration (VA) and possibly the CDC responsible for failing to protect veterans and other vulnerable consumers from the perils of addiction?

This program has been approved for 4 ethics CLE credits for Pennsylvania lawyers. CLE credit may be available in other jurisdictions as well. Attendees seeking CLE credit should bring separate payment in the amount of $160.00 ($80.00 public interest/non-profit attorneys) cash or check made payable to The Trustees of the University of Pennsylvania.


Participants

Professor Evan Anderson

JD, PhD, Center for Public Health Initiatives, University of Pennsylvania

Dr. Michael Ashburn

Professor of Anesthesiology and Critical Care Director, Pain Medicine and Palliative Care, Penn Pain Medicine Center

Mr. Robert Ashford

Founder, Quaker Peer Recovery; Member of Mayor Kenney’s Task Force to Combat Opioid Epidemic in Philadelphia

Ms. Susan Baren-Pearson

Counseling and Health Services, Drexel University

Mr. B

lake BeeProgram Counsel, National Association of Attorneys General Center for Consumer Protection

Ms. Bridget G. Brennan

Special Narcotics Prosecutor for New York City

Ms. Janet L. Brennan

Founder & Executive Director, Shamrock Reins

Attorney General Chris Carr

Attorney General of Georgia

Ms. Jenna Damico

Department of Psychology, Drexel College of Arts and Sciences

Dr. Steve Daviss

Senior Medical Advisor, Office of the Chief Medical Officer and Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA)

Professor Kit Delgado

Assistant Professor for Emergency Medicine, Perelman School of Medicine, University of Pennsylvania

Mr. Ralph DeLucia

Associate Director, Penn Office of Affirmative Action & Equal Opportunity Programs

Attorney General Matt Denn

Attorney General of Delaware

Mr. Chris Diaz

Executive Director, Action Tank; CEO and Founder, Serve 1

Ms. 

Gerianne Tringali DiPianoPresident and CEO, FemmePharma

Judge Patrick Dugan 

Chief Judge, Philadelphia Veterans Court

Dr. Thomas Farley

Health Commissioner, City of Philadelphia

Ms. Arlene Fickler

 Partner, Schnader Attorneys At Law,  CERL Board Member

Mr. Benjamin Field

Assistant City Solicitor for Philadelphia

Professor Claire Finkelstein

Director, CERL; Algernon Biddle Professor of Law and Professor of Philosophy, University of Pennsylvania Law School

Ms. Melissa Francis

 Assistant District Attorney, Philadelphia District Attorney’s Office

Professor Shannon Frattaroli

Associate Professor, Johns Hopkins Bloomberg School of Public Health

Mr. Jonathan Garelick

Deputy Chief of Staff,  New Jersey Office of the Attorney General

Ms. Vanessa Garrett Harley

Chair, Social Services Law Group, City of Philadelphia Law Department

Dr. Eric Goplerud

VP and Senior Fellow, Public Health Department, NORC at the University of Chicago

Mr. Gregory Heller

Attorney, Young, Ricchiuti, Caldwell & Heller

Mr. Josh Horwitz

Executive Director, the Coalition to Stop Gun Violence

Mr. Bryan Hughes

Assistant Attorney General of Philadelphia

Ms. Maura Kennedy

Director of Business and Sponsorships, The American Law Journal

Dr. Andrew Kolodny

Co-director of the Opioid Policy Research Collaborative, Brandeis University

Mr. Noah Lewellen

Assistant Attorney General, Office of Minnesota Attorney General

Ms. Denise Maldonado-Rosa

Assistant Attorney General, Office of Puerto Rico Attorney General

Mr. Neil Mara

Deputy Chief, Special Litigation and Civil Rights, PA Office of Attorney General

Mr. Andrew S. Margolis

President, A Margolis Realty Co

Mr. Matthew Miclette

Policy Associate, Penn Leonard Davis Institute of Health Economics 

Mr. Donald Migliori

Attorney, Motley Rice

Mr. Chris Mondics

Legal Affairs Journalist, formerly of The Philadelphia Inquirer 

Mr. Christopher Naughton

Attorney/Host, The American Law Journal

Mr. Michael O’Bryan

Urban Innovation Fellow, Lindy Institute for Urban Innovation

Mr. Leigh Owens

Director of Community Engagement, Office of District Attorney of Philadelphia 

Dr. Steven Peskin

Senior Medical Director, Clinical Innovations, Horizon Healthcare Innovations – Horizon BlueCross Blue Shield of New Jersey

Ms. Meagan Pharis

Senior Associate, Philadelphia Research Initiative, The Pew Charitable Trusts

Dr. Jennifer Prah Ruger

Amartya Sen Professor, Health Equity, Economics, and Policy, School of Social Policy & PracticeAssociate Dean, Global Studies, School of Social Policy & PracticeCouncilwoman Maria D.Quiñonas-Sánchez                         District 7, City Council of Philadelphia

Dr. Mitchell S. Rosenthal

Founder and President, Rosenthal Center for Addiction Studies, Phoenix House Foundation

Dean Theodore Ruger

Dean and Bernard G. Segal Professor of Law, University of Pennsylvania Law School

Ms. Diane Sandefur

Director, TRIO Veterans Upward Bound, VPUL Equity and Access Programs, University of Pennsylvania

Mr. Muhammad Sarahne

SJD Candidate, University of Pennsylvania Law School

Ms. Tiffany Sedillos

Assistant Attorney General, Minnesota’s Attorney General’s Office

Mr. Andrew Schaeffer

The American Law Journal 

Mr. Stephen Sheller

Founding Partner, Sheller P.C. Law Firm & Honorary Doctor of Humane Letters, Drexel University

Ms. Sandy Sheller

President and Director, Sheller Family Foundation

Mr. Stephen St. Vincent

Director, Policy & Planning, PA Office of Attorney General

Dr. Cassandra Steer

Acting Executive Director, CERL

Ms. 

Roseann B. TerminiFood and Drug Law, Widener University School of Law

Ms. Joanne E.Thomka

Program Counsel, National Association of Attorneys General

Mr. Edwin R. Thompson

President, PMRS, Inc.

Dr. Rebecca Weidensaul

Asst. Vice President, Drexel University Student Life

Dr. Stephen N. Xenakis

Brigadier General (Ret), U.S. Army, CERL Board Member

Background Readings

“2016 Overdoses From Opioids in Philadelphia.” Philadelphia Department of Health. Apr 2017.

BREAKING: Millions in Payments Among Findings of McCaskill Opioid Investigation into Ties Between Manufacturers and Third Party Advocacy Groups“ [Press release], The Office of US Senator Claire McCaskill, 12 Feb 2018.

Chan, Mitchell. “Penn Law conference explores PTSD among veterans.” The Daily Pennsylvanian, 12 Dec 2015.

City of Chicago v. Purdue Pharma (Illinois 2016).

Complaint in Philadelphia Opioid Case.” Jan 2018.

Corkey, Michael and Katie Thomas. “Drug Industry Wages Opioid Fight Using an Anti-Addiction Ally.” The New York Times, 8 Feb 2018

Dannunzio, P.J. and Max Mitchell. “Krasner, New Task Force at Odds on Key Issue in Opioid Fight.” The Legal Intelligencer, 22 Feb 2018.

Davidson, Joe. “Veterans’ health-care gap creates ‘greater risk’ for opioid abuse.” The Washington Post, 7 Aug 2017.

“Doctor Sentenced for Health Care Fraud.” FDANews. 15 March 2018.

Eleventh Judicial Circuit Criminal Mental Health Project.

Eyre, Eric. “Drug firms shipped 20.8M pain pills to WV town with 2,900 people.” Charleston Gazette-Mail, 29 Jan 2018.

Feldman, Nina. “ERs in Pennsylvania, Delaware report huge increased in opioid overdoses.” WHYY. 7 Mar 2018;

“Final Report of the President’s Commission on Combatting Drug Addiction and the Opioid Crisis (2017)”

Gupta, Rahul. Opioid Response Plan for the State of West Virginia, Feb 2018.

Harris, Robert E., et al. “Perceptions about supervised injection facilities among people who inject drugs in Philadelphia.” International Journal of Drug Policy. 17 May 2017.

Hellmann, Jessie. “Trump administration ends registry for substance abuse, mental health programs.” The Hill, 10 Jan 2018.

Higma, Scott and Lenny Bernstein. “The Drug Industry’s Triumph over the DEA.” The Washington Post, 15 Oct 2017.

Hoffman, Jan. “In Opioid Battle, Cherokee Want Their Day in Tribal Court.” The New York Times, 17 Dec 2017.

“HookedRx: From Prescription to Addiction.” Cronkite News.

Iglehart, John K.  “Decriminalizing Mental Illness – The Miami Model.” The New England Journal of Medicine, 5 May 2016.

“The Intersection of Opioid Overuse and Veteran Mental Health Challenges.” CERL Report, 13 January 2017.

Johns Hopkins Bloomberg School of Public Health. The Opioid Epidemic: From Evidence to ImpactOctober 2017.

Kamienski, Łukasz, “Helping Postmodern Ajax: Is Managing Combat Trauma Through Pharmacology a Faustian Bargain?”, 39 Armed Forces & Society 395 – 414 (212).

Keefe, Patrick Radden. “The Family That Built an Empire of Pain.” The New Yorker, 30 Oct 2017. 

Keene, Matthew. “Let’s fix the cause, rather than the problem, of opioid addiction.” The Hill, 30 Nov 2017.

Killough, Ashley. “Senators unclear on Trump’s comment about opioid crisis.” CNN, 11 Jan 2018.

Levine, Art. “How the VA Fueled the National Opioid Crisis and is Killing Thousands of Veterans.” Newsweek, 12 Oct 2017.

Lilly, Jessica and Roxy Todd, “Inside the Appalachian Opioid Epidemic Part 2: Veterans, Chronic Pain & Alternative Treatment.” WV Public Broadcasting, 28 April 2017.

McFadden, Cynthia, Brenda Breslauer, and Tracy Connor. “Can commissioner Scott Gottlieb undo FDA missteps in opioid crisis?” NBC News, 23 Jan 2018.

Mitchell, Max. “Krasner Files Consumer Protection Suit Over Opioid Crisis.” The Legal Intelligencer, 16 Feb 2018.

Mukherjee, Sy. “What’s Killing America’s Veterans? Here’s What the Data Says.” Fortune, 10 Nov 2017.

Newhouse, Eric. “VA Says 68,000 Vets Addicted to Opioid Painkillers.”Psychology Today, 23 Jan 2017.

“Opioid crisis linked to two-year drop in US life expectancy”BBC News, 22 Dec 2017.

“The Opioid Epidemic in Philadelphia: Implementation of the Mayor’s Task Force Recommendations.” Philadelphia Department of Public Health. 13 Sep 2017.

Purdue Pharma statement on The Uncertain Hour’s OxyContin episode”, Marketplace, December 13, 2017.

Rosenberg, Tina. “Philadelphia, a City Stalked by Overdoses, Fights Back.” The New York Times, 20 Feb 2018.

Ross, Casey. “A South Texas county drags PBMs into nationwide lawsuit over opioids.” Stat News, 26 Feb 2018. 

Seelye, Katharine. “How a ‘Perfect Storm’ in New Hampshire Has Fueled an Opioid Crisis.” The New York Times, 21 Jan 2018.

“Short-Course Treatment for Combat-Related PTSD Offers Expedited Path to Recovery”Penn Medicine News, 23 Jan 2018.

Slack, Donavon.  “VA publicly releases opiate prescribing rates for all its hospitals for the first time.” USA Today, 11 Jan 2018.

Sullum, Jacob. “America’s War on Pain Pills is Killing Addicts and Leaving Patients in Agony.” Reason.com. Apr 2018.

“Summary prepared by Sheller, P.C. Law Firm: orders by the courts in NJ & PA keeping critical documents sealed from the public in the Risperdal Litigation.”

Teeters, Jennie. “Substance use disorders in military veterans: prevalence and treatment challenges.” The National Center for Biotechnology Information, 30 Aug 2017.

United States Senate Homeland Security and Governmental Affairs Committee, Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups, 12 Feb 2018.

Vivolo-Kantor, Alana M., et al. “Vital Signs in Emergency Department Visits for Suspected Opioid Overdoes – United States, July 2016-September 2017.” Morbidity and Mortality Weekly Report. 6 Mar 2018. 

Walters, Joanna “New York City sues ‘Big Pharma’ for $500m for fueling opioid epidemic.” The Guardian, 23 Jan 2018.

Contact us

For any questions regarding the conference or registration, please contact: Jennifer Cohen at [email protected]

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Legal Responses to the Opioid Addiction Crisis