U.S. Surgeon General: Warm Handoffs Are ‘Immediate Priority’

On Thursday, October 24, the Senate Finance Committee held a full committee hearing on the topic of substance abuse in the United States. Among the witnesses was the Surgeon General of the United States, Jerome M. Adams, MD, MPH. Dr. Adams detailed the current approach of the Department of Health and Human Services (HHS), highlighted reasons for optimism, and identified areas where continued efforts are necessary.

Dr. Adams stated that “HHS’s immediate priorities include…emergency department medication-assisted treatment (MAT) programs with warm handoffs following overdose…”.

Two of DCBA’s attorneys, Michael C. Barnes and Daniel C. McClughen, authored one of the first-ever law review articles on the topic of warm-handoffs. The article was published in the Fall 2018 issue of the University of Memphis Law Review. Barnes and McClughen have continued their work on warm handoffs through the Warm Handoff Initiative, an initiative of the Center for U.S. Policy.

Read the entire testimony of the Surgeon General and other witnesses.

Read the Barnes & McClughen article on warm-handoffs.

Learn more about the Warm Handoff Initiative.

Aggressive DOJ Actions Against Opioid Prescribers Continue

An article published yesterday by Pain News Network’s Pat Anson tells the story of yet another physician who has faced threats from the Department of Justice (DOJ) due to the use of opioids within his practice. Dr. Roger Kasendorf, a physician from Southern California, paid a settlement of $125,000 rather than defend against allegations of illegal opioid prescribing.

Dr. Kasendorf claims the allegations were an effort to extort him and were based solely on inadequate recordkeeping, rather than any actual evidence of illegal prescribing habits. He agreed to settle on the advice of his attorney, who said that paying the settlement would more economically sensible than fighting the allegations.

DCBA Managing Partner Michael C. Barnes is quoted in the article, weighing in on the potential legitimacy of Dr. Kasendorf’s extortion claim. “Without reviewing the medical records, I cannot assess the fairness of this outcome. If the physician were merely a big-data outlier because he took on patients with the most complex needs, and if his prescribing were CSA (Controlled Substances Act)-compliant, then the behavior of the federal government would fall squarely under the Black’s Law Dictionary definition of extortion.”

Barnes also stressed how important it is for practitioners to maintain thorough, accurate, and up-to-date records. “The DOJ treats controlled-medication prescribers, especially big-data outliers, as though they are guilty until proven innocent. Detailed medical records are the only affordable way for a provider to prove his innocence – or at least make the prosecutor think twice about proceeding with criminal charges.”

Read the full article here.

Is Opioid Pharma Hatred Doing More Harm Than Good?

On October 17, 2019, Filter published an article titled “Why Opioid Pharma Hatred Is Overblown and Harmful,” which featured an interview with DCBA Managing partner Michael C. Barnes. The article’s author, Alison Knopf, shed light on the nuances of the overdose crisis that are often overlooked in mainstream media narratives, with particular focus on the vilification of the pharmaceutical industry and the harm caused to patients with pain.

In the article, Barnes discussed the skewed media coverage of opioid-related litigation and pointed out that people may find it less difficult to lay blame solely on pharmaceutical companies for tragic overdoses, which are actually caused by a confluence of factors.

Barnes explained how the use of public nuisance, the legal strategy being used to fight opioid companies in court, may set off a slippery slope for cases involving the makers of other drugs and products that can be abused. Barnes emphasized that the connection between the drug companies’ activity and the overdose crisis is far more complex than the public tends to acknowledge, and using this legal strategy fails to adequately acknowledge the role of actors like pharmacists, prescribers, drug diverters, and patients.

To read the full article, click here.

Emergency Responses to Substance Abuse, Mental Illness

DCBA Law’s Managing Partner Michael C. Barnes spoke today at the Choctaw Nation Health Services Authority Conference in Durant, Oklahoma. Barnes’ presentation, “Compassion and Common Sense: Emergency Responses to Substance Abuse and Mental Illness,” provided information on the nation’s overdose crisis and delved into some of the major initiatives that have been undertaken at the federal and local levels to address it. Barnes discussed warm handoff programs, which transition a patient with substance use disorder (SUD) from an intercept point to treatment once the patient is stable; the use of naloxone to reverse overdoses; and privacy issues such as HIPAA and 42 CFR Part 2, which affect disclosure of overdose incidents. Barnes then highlighted the use of telehealth programs and mobile medical services to treat individuals with SUDs. The presentation also touched on pre-arrest diversion programs, which give officers discretion to divert individuals who commit low-level, nonviolent misdemeanor offenses out of the criminal justice system, as well as how state civil commitment laws apply to individuals with SUDs. Barnes ended the presentation by discussing how to overcome some of the major barriers to implementing and sustaining such programs.

Barnes is a member of the All American Speakers Bureau.

DCBA Managing Partner Presents on Federal Law, Regulation, Enforcement, and Impacts on Pain Management at ASPMN

On September 19, 2019, DCBA Managing Partner Michael C. Barnes presented alongside Wade Delk, Government Affairs Director of the American Society for Pain Management Nursing (ASPMN), and Marsha Stanton, Ph.D., R.N., former president of ASPMN, at ASPMN’s 29th annual conference in Portland, Oregon. Their presentation, titled “Trends in Federal Law, Regulation, and Enforcement, and Their Impacts on Pain Management Practice,” focused on recent federal efforts to crack down on opioid prescribers and decrease prescribing rates, as well as the unintended consequences of indiscriminate supply-reduction efforts on patients with pain. The speakers also discussed efforts from the pain community, advocates, and physicians to raise awareness of the harmful impacts of federal responses to the overdose crisis. The presentation then described several federal initiatives to examine the topic of chronic pain, including the Pain Management Best Practices Inter-Agency Task Force and the National Institute of Health’s HEAL Initiative. Finally, the speakers highlighted several legislative and policy approaches of relevance to pain management, including the use of cannabidiol (CBD); the X the X waiver campaign, which aims to relax restrictions on buprenorphine prescribing for opioid use disorder; and health care reform proposals from both sides of the political aisle.