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Big question in opioid suits: How to divide any settlement
By GEOFF MULVIHILL | Mon, July 29, 2019 02:48 EDT
The roughly 2,000 state and local governments suing the drug industry over the deadly opioid crisis have yet to see any verdicts or reach any big national settlements but are already tussling with each other over how to divide any money they collect.
The reason: Some of them want to avoid what happened 20 years ago, when states agreed to a giant settlement with the tobacco industry and used most of the cash on projects that had little to do with smoking’s toll.
“If we don’t use dollars recovered from these opioid lawsuits to end the opioid epidemic, shame on us,” Kentucky Attorney General Andy Beshear said.
Overdoses from opioids, which include prescription painkillers and illegal drugs like heroin, have surpassed automobile crashes in recent years as the biggest cause of accidental deaths in the U.S., accounting for the loss of more than 400,000 lives since 2000.
An Associated Press analysis found that by 2011 and 2012, the industry was shipping enough prescription opioids to give every man, woman and child in the U.S. nearly a 20-day supply each year.
In their lawsuits, the governments contend the brand-name manufacturers fraudulently downplayed the addiction risks of the powerful painkillers while encouraging doctors to prescribe their patients more drugs and at higher doses. They also argue that drugmakers and distributors failed to stop suspiciously large shipments. The defendants dispute the allegations.
In the late 1990s, attorneys general for all 50 states reached colossal settlements under which tobacco companies would pay them forever. A tally by the Campaign for Tobacco-Free Kids found states have received more than $161 billion so far.
But some of the money has gone toward such things as roads, bridges or teacher pensions. Some of the money went into states’ general fund accounts, available for all sorts of uses.
“Most states have used their settlement recoveries, which are massive, for everything but the problem that gave rise to the litigation,” said Doug Blake, a former Minnesota assistant attorney general who worked on the state’s tobacco settlement.
The anti-smoking group says that for the fiscal year that ended in June, states took in $27.3 billion from the settlements and from tobacco taxes and spent just 2.4% of that on kick-the-habit and smoking-prevention programs. The group also found that states spend, on average, less than one-fifth of what the U.S. Centers for Disease Control and Prevention recommends on anti-smoking programs.
In the opioid litigation, plaintiffs want to make sure the money goes toward treating addiction and preventing drug abuse. Some also want to be reimbursed for extra taxpayer costs associated with the epidemic, such as rising expenses for jails and mental health services, more ambulance runs and police calls, and more children of addicts placed in the care of the child-welfare system.
There have been disputes within states over who should allocate money from opioid-related settlements. In Oklahoma, lawmakers objected earlier this year when the state attorney general struck a deal with Purdue Pharma that allocated much of a $270 million settlement to a center for treatment and research. The lawmakers said they should be the ones to make those decisions. Lawmakers in West Virginia are asking the attorney general there to let them allocate the $37 million settlement with the drug distributor McKesson.
Close to 2,000 local governments have made claims against the drug industry. While the states’ lawsuits are in state court, most of the city and county claims are in federal court, where they have been consolidated under one Cleveland-based judge who is pushing for a settlement.
Joe Rice, an architect of the tobacco settlement and one of the lead lawyers in the opioid cases, with clients including both local governments and states, said local governments are suing partly because they think they can do a better job with the money than states did with the tobacco funds. Rice noted the opioid crisis has run up costs for local governments in ways cigarettes did not.
New Jersey’s Camden County, for instance, started allocating extra money for its Office of Mental Health and Addiction to deal with problem back in 2015. That first year, the county of a half-million people just outside Philadelphia kicked in $150,000. This year, it is up to $600,000.
The sum does not include other crisis-related costs sprinkled throughout the county budget: $156,000 for opioid treatment for jail inmates, cleaning up “needle parks” and holding an annual recovery softball game.
In the event of a nationwide settlement, Rice and other lawyers representing local governments have proposed a plan that would set in advance how much county and local governments would get, based on the amount of drugs shipped there, the overdose deaths and the number of people addicted.
In the case of a $1 billion national settlement, for instance, Camden County would get $1.3 million, and the communities in the county would share an additional $900,000.
But many attorneys general have asked U.S. District Judge Dan Polster not to approve the plan. Thirty-eight warned in a filing this month that the process “would make ‘global peace’ more, not less, difficult to achieve.”
The states also worry about the wisdom of splitting settlement funds with local governments.
“Doling out small buckets of funds without regard to how the funds should be spent is the opposite of a ‘coordinated’ response, which would balance statewide efforts — such as public education campaigns — with any local efforts,” the attorneys general wrote.
Follow Mulvihill at http://www.twitter.com/geoffmulvihill
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Iranians say US sanctions blocking access to needed medicine
By MOHAMMAD NASIRI 08:28 EDT
TEHRAN, Iran (AP) — Taha Shakouri keeps finding remote corners to play in at a Tehran children’s charity hospital, unaware that his doctors are running out of chemo medicine needed to treat the eight-year-old boy’s liver cancer.
With Iran’s economy in free fall after the U.S. pullout from the nuclear deal and escalated sanctions on Tehran, prices of imported medicines have soared as the national currency tumbled about 70% against the dollar. Even medicines manufactured in Iran are tougher to come by for ordinary Iranians, their cost out of reach for many in a country where the average monthly salary is equivalent to about $450.
Iran’s health system can’t keep up and many are blaming President Donald Trump’s “maximum pressure” campaign for the staggering prices and shortages. The sanctions have hurt ordinary Iranians, sending prices for everything from staples and consumer goods to housing skyward, while raising the specter of war with the U.S.
Taha’s mother, Laya Taghizadeh, says the hospital provides her son’s medication for free — a single treatment would otherwise cost $1,380 at a private hospital. She adds the family is deeply grateful to the doctors and the hospital staff.
“We couldn’t make it without their support,” says the 30-year-old woman. “My husband is a simple grocery store worker and this is a very costly disease.”
The Iranian rial has plunged from 32,000 to $1 at the time of the 2015 nuclear deal between Tehran and world powers to around 120,000 rials to the dollar these days, highly affecting prices of imported medicines. The nuclear deal had raised expectations of a better life for many Iranians, free of the chokehold of international sanctions.
The landmark accord lifted international sanctions in exchange for curbs on Iran’s nuclear program, but now the deal has all but unraveled and new and tougher U.S. sanctions are in place.
While the United States insists that medicines and humanitarian goods are exempt from sanctions, restrictions on trade have made many banks and companies across the world hesitant to do business with Iran, fearing punitive measures from Washington. The country is cut off from the international banking system.
Last week, Health Minister Saeed Namaki said budget cuts because of the drop in crude exports have dramatically affected his department. The U.S. sanctions have targeted all classes of Iranians, he added.
“The American claims that medicine and medical equipment are not subject to sanctions is a big and obvious lie,” Namaki said.
“Our biggest concern is that channels to the outside world are closed,” said Dr. Arasb Ahmadian, head of the Mahak Children’s Hospital, which is run through charity donations and supports some 32,000 under-16 children across Iran.
The banking sanctions have blocked transactions, preventing donations from abroad, he said. Transfers of money simply fail, including those approved by the U.S. Treasury.
“Indeed, we are losing hope,” said Ahmadian. “Medicines should be purchasable, funding should be available and lines of credit should be clearly defined in the banking system.”
Official reports say Iran produces some 95% of the basic medicines it needs and even exports some of the production to neighboring countries.
But when it comes to more sophisticated medication and medicines for costly and rare illnesses and medical equipment, Iran depends heavily on imports. And though the state provides health care for all, many treatments needed for complicated cases are simply not available. Many prefer to go to private hospitals if they can and avoid long waiting lists at state ones.
Long lines form every morning in the 13-Aban Pharmacy in central Karimikhan Street, where people come looking for rare medicines for sick family members.
Hamid Reza Mohammadi, 53, spends much of his free time going in search of drugs for his wife and daughter, both of whom suffer from muscular dystrophy.
“Two, three months ago I could easily get the prescription filled in any pharmacy,” Mohammadi said, reflecting how quickly things have deteriorated.
Pharmacist Peyman Keyvanfar says many Iranians, their purchasing power slashed, cannot afford imported medicines and are looking for domestically manufactured substitutes. “There has been a very sharp increase in the prices of medicines, sometimes up to three to four times for some,” he said.
Those who still have some cash often turn to the black market.
Mahmoud Alizadeh, a 23-year-old student, rushed to the shady Nasser-Khosrow Street in southern Tehran when he got word his mother’s multiple sclerosis drug was available there.
“She is just 45 years old, it’s too soon to see her so badly paralyzed,” he said.
He pays three times more for the drug on the street than he did in May 2018. “I don’t know on whom Trump imposed sanctions except that he is punishing terminally ill people here.”
Many travel from rural areas to bigger cities in search of drugs for their loved ones.
Hosseingholi Barati, a 48-year-old father of three, came to Tehran from the town of Gonbad Kavus, about 550 kilometers (350 miles) to the northeast, looking for medication for his leukemia-stricken wife. He says he has spent $7,700 so far on her illness.
“It’s a huge strain,” he said. “I have sold everything I owned and borrowed money from family and friends.”
EarthLink – News
Trump takes clemency actions in several cases
Mon, July 29, 2019 06:51 EDT
WASHINGTON (AP) — President Donald Trump has pardoned five men convicted of crimes including theft, fraud and drug trafficking, in addition to commuting the sentences of two others.
The president commuted the sentences of Ted Suhl, who was convicted of bribery related to Medicaid fraud, and Ronen Nahmani, a Florida man convicted of selling synthetic marijuana. The White House says he has five young children and that his wife is suffering from terminal cancer.
Trump’s clemency actions to date have tended to focus on household names and conservatives, including champion boxer Jack Johnson, former Arizona Sheriff Joe Arpaio, conservative commentator Dinesh D’Souza and media mogul Conrad Black. He also freed Alice Johnson, who was serving life without parole for drug offenses, after her case was championed by reality star Kim Kardashian West.
EarthLink – News
Block party shootout may have been gang related, police say
By MICHAEL R. SISAK | Mon, July 29, 2019 07:51 EDT
NEW YORK (AP) — A shootout that left one man dead and 11 people wounded at a Brooklyn community festival over the weekend may have been gang related, the New York Police Department said Monday as the hunt continued for at least two gunmen.
Several victims of the shooting late Saturday had gang histories, including the man who was killed, Chief of Detectives Dermot Shea said. But “whether or not that played any role” has not been determined, Shea said.
Commissioner James O’Neill said police are looking at the possibility of gang involvement, in part because gang violence accounts for about half the shootings in that area of the city.
The neighborhood, Brownsville, had a violent crime rate last year that was more than double the citywide average. It is one of six areas receiving special attention from the police department to drive down crime.
Brownsville’s annual Old Timers Day event, a two-day block party featuring musical performances from former residents and current local talent, was coming to a close and the crowd was dispersing when gunfire erupted in a playground at the recreation center where it was being held.
Jason Pagan, 38, died of a gunshot wound to the head. He was a member of the Bloods gang, Shea said, adding that it wasn’t yet clear if he was a target of the shooting.
“We still don’t have who was shooting at who,” Shea said.
Pagan, who police said lived about five blocks from the park, was released on parole in January after more than two years in prison on a weapons charge.
Six men and five women between ages 21 and 55 were hospitalized with gunshot wounds. One person who was listed in critical condition is now in serious condition, Shea said.
In a story on the front pages of the city’s tabloids, 21-year-old college student Daniesa Murdaugh credited her bra with stopping a bullet and saving her life.
No arrests have been made. Police said they believed there were at least two gunmen. One gun was recovered at the scene.
Asked at a news conference Monday how many suspects were being sought, Shea said police “will look for as many as were involved,” adding that authorities have received several tips from community members.
Videos on social media showed police clearing large groups of people out of the area around the park. Authorities asked anyone with information or video of the shooting to come forward.
Later Monday, community leaders and residents convened at the site of the festival for an anti-violence march. Images posted to social media by elected officials, news reporters and others showed a crowd, some in T-shirts honoring the Old Timers Day tradition, and marching through nearby streets in a procession that stretched for multiple blocks.
“Brownsville in, violence out!” some chanted.
The Old Timers Event has been an annual tradition in Brownsville since 1963 and has grown to attract crowds of about 5,000 people on Friday night and about 10,000 people on Saturday night, O’Neill said.
New York City Mayor Bill de Blasio said the event was an “example of everything good about the Brownsville community” and decried the shooting as a “tragedy.”
O’Neill said more than 100 police officers were on duty at the festival and quickly jumped into action when the shooting started.
He said police will review security procedures for the festival and other events in the city and make changes where necessary.
Follow Sisak on Twitter at twitter.com/mikesisak
EarthLink – News
Chinese official praises Xinjiang camps as ‘pioneering’
Tue, July 30, 2019 03:57 EDT
BEIJING (AP) — Officials from China’s northwestern Xinjiang region said Tuesday that most of the people who were in the area’s controversial re-education centers have since left the facilities and signed “work contracts” with local companies.
The U.S., human rights groups and independent analysts estimate around 1 million Muslims have been arbitrarily detained in Xinjiang’s heavily guarded internment camps, which the Chinese government calls vocational training centers. The region is home to Uighurs, Kazakhs and other predominantly Muslim ethnic minority groups.
Shohrat Zakir, Xinjiang’s Uighur governor, declined to give a figure for those he called “students” inside the centers during a news briefing. Zakir defended the facilities as an effective and “pioneering” approach to counterterrorism.
“Most of the graduates from the vocational training centers have been reintegrated into society,” Zakir said. “More than 90% of the graduates have found satisfactory jobs with good incomes.”
Xinjiang Vice Chairman Alken Tuniaz said accounts of mistreatment in the camps were concocted by a few countries and media outlets.
Former detainees and their family members have said in interviews with The Associated Press that the re-education centers resembled prisons where they were forced to renounce their faith and swear loyalty to China’s ruling Communist Party. They said they were subject to repeated political indoctrination and often did not understand why they were being held in the facilities.
Travelling overseas, speaking to relatives abroad and growing an excessively long beard are all acts that might land someone in detention, according to Uighurs and Kazakhs who have fled the region.
They have also told The AP that some detainees were forced into factory jobs. They were taken to a government office and handed labor contracts for six months to five years in a distant factory, which they were required to sign, according to one detainee who spoke on the condition of anonymity.
Tuniaz said the centers protected people’s liberties by allowing them to “request time off” and “regularly go home.” While the people inside the centers are not permitted to practice their religion during their “period of study,” they can resume activities related to their faith when they are at home. The officials Tuesday did not address whether the program is voluntary or how often people are allowed to go home.
After international condemnation of and extensive reporting on the centers, China began organizing highly choreographed trips to Xinjiang for journalists and foreign officials. Earlier this month, United Nations envoys from 37 countries including North Korea, Syria and several Muslim-majority states, signed a letter supporting the camps and commending China’s human rights record.
Dilxat Raxit, spokesman for the World Uyghur Congress, called Zakir a “political microphone” used by Beijing to spread its “deception.”
“Shohrat Zakir’s remarks completely distort the reality of the systematic persecution that Uighurs are suffering in China,” Raxit said.
The U.S. State Department’s counterterrorism coordinator, Nathan Sales, said in a July interview with the U.S. government-funded Radio Free Asia that the detentions of Muslims in Xinjiang had “nothing to do with terrorism” and was instead part of the Communist Party’s “war on religion.”
“It is trying to stamp out the ethnic, linguistic, cultural and religious identities of the people that it’s been targeting,” Sales told RFA.