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Opioid Makers Insys Agree To Pay Settlement Of $225 Million 

Published July 3, 2019 by ADRAS & ALTIG, Attorneys at Law
person bribing a doctor

The epidemic of opioid abuse has touched many lives in Nevada. The possession of an opioid without a valid prescription or the use of a fraudulent prescription to obtain opioids is a criminal offense in Nevada.

Opioids are highly addictive. The criminal defense attorneys at Adras & Altig in Las Vegas represent clients accused of drug crimes. Our attorneys understand that many good people get addicted to opioids. In many cases, they need substance abuse treatment rather than punishment to address their addiction issues. Some doctors and other health care providers have gotten caught up in the opioid epidemic and been charged with illegally prescribing opioids and other controlled substances.

A recent case focusing on a drug manufacturer’s marketing practices involved alleged white-collar crimes such as bribery and fraud. The case involves drug manufacturer Insys Therapeutics, which has admitted to bribing doctors to prescribe its highly addictive opioid painkiller. Insys agreed to pay $225 million to settle the federal government’s criminal and civil investigations into the company’s marketing practices.

A federal jury in Boston found five top Insys Therapeutics executives, including founder John Kapoor, guilty of racketeering conspiracy for these same practices in May, National Public Radio reported. 

Five days after agreeing to the settlement, Insys Therapeutics filed for Chapter 11 bankruptcy, to allow the business to keep operating as it restructures its finances to pay the fine and legal expenses. 

Racketeering, or RICO, charges are federal charges typically leveled against multiple people in a series of indictments. This case also raises questions about charges related to prescription drug fraud, such as illegal opioid sales.

Several Insys employees and doctors have already been convicted in other cases of participating in a kickback scheme, the Associated Press reports. A number of states have sued the company, which agreed to pay $150 million to settle a federal investigation into inappropriate sales.

Prescribing a Highly Addictive Opioid Without Need

The New York Times describes Subsys, the Insys Therapeutics drug under fire, as “a highly addictive fentanyl painkiller.” The National Institute on Drug Abuse (NIDA) describes fentanyl as a powerful synthetic opioid that is similar to morphine but 50 to 100 times more potent.

The NIDA says that synthetic opioids, including fentanyl, are the most common drugs involved in drug overdose deaths in the United States.

According to NPR, Insys Therapeutics admitted orchestrating a nationwide scheme in which it set up a sham “speaker program” that paid participating doctors not to give speeches but to write prescriptions of Subsys. “Often the painkiller was prescribed to patients who did not need it,” NPR says.

The company’s website says Subsys, which is sprayed under the tongue, is for emergency pain relief among cancer patients who are already taking opioids around-the-clock. Subsys is started only after you have been taking other opioid pain medicines and your body has become used to them (you are opioid tolerant). 

Prosecutors said Insys used lavish dinners and other events to entice doctors to prescribe more of its product, according to The Times. The scheme also included hiring a former exotic dancer as a regional sales manager to persuade doctors to prescribe the drug, Alec Burlakoff, former vice president of sales at Insys Therapeutics, testified in March. 

Insys staffers misled insurers about patients’ medical conditions and posed as doctors’ office employees to get payments approved for the costly drug, prosecutors said.

A physician assistant in New Hampshire who had never previously prescribed the drug joined the company’s speaker program and afterward wrote 672 Subsys prescriptions and was paid $44,000 from Insys, which prosecutors said amounted to illegal kickbacks.

The AP describes one recipient of the fentanyl spray:

Sarah … was being treated for fibromyalgia and back pain when an Insys sales representative and her doctor met with her at her doctor’s New Jersey office to persuade her to begin taking Subsys, according to a lawsuit her parents filed against Insys.

In an order to get Sarah approved for the drug, an Insys employee duped the pharmacy benefit manager into believing that the employee worked for the doctor’s office and that she was suffering from cancer pain, the lawsuit says.

She died of an overdose a little over a year later at age 32.

“Sarah didn’t have cancer, so there was no reason for her to have been on it,” said her mother. “There are a lot of things she should have been able to do, but her life was cut short by people who just don’t care,” she said.

Fuller’s doctor wasn’t accused of getting kickbacks and was not criminally charged, The AP says. But she lost her license after state officials found she was “indiscriminately” prescribing Subsys to patients without cancer.

Opioid Epidemics in Nevada and How Our Lawyers Can Help

In Las Vegas, the Department of Justice funded a dedicated opioid prosecutor for the United States Attorney’s Office for the District of Nevada in 2017 and, early this year, federal officials announced Operation Hypocritical Oath, a multi-state effort to investigate physicians in Nevada who illegally prescribe controlled substances. 

In June, two Las Vegas doctors, an unlicensed nurse and two others were arrested and indicted for trafficking in an opioid classified as a Schedule III controlled substance. Additional charges include distribution of Valium, obtaining a controlled substance by misrepresentation and maintaining drug-involved premises.

The National Institute on Drug Abuse (NIDA) says Nevada providers issued prescriptions for opioids at a higher rate than the national average. They wrote 73 opioid prescriptions for every 100 people in the state in 2017, compared to the average U.S. rate of 58.7. 

There were 412 overdose deaths involving opioids in Nevada in 2017, according to NIDA. The highest number of deaths in 2017, 276, involved prescription opioids, NIDA says. Synthetic opioids other than methadone — predominantly fentanyl — were involved in 66 overdose deaths that year.

If you have a problem with opioid use or any drug addiction, there is help available, including free treatment options here in Las Vegas. If you have been charged with a drug crime, Adras & Altig can represent you and seek the best possible resolution to your case, which may include a diversion program that includes treatment.

At Adras & Altig, we are criminal defense attorneys with years of experience in Las Vegas and throughout Clark County, Nevada. We are here to help, not judge. Contact us today and we will help you.

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