Opioid trial witness: Distributors ignored red flags suggesting illicit drug use

Drug distributors continued to ignore red flags signaling that doctors, pharmacists and other customers had diverted opioids intended for the treatment of pain for illicit uses, a former high-ranking Drug Enforcement Administration official testified Thursday.

Every drug distributor registered with the DEA received letters in 2007 and 2008 explaining that they had to establish systems to detect customers who requested unusually large orders or increased the frequency of orders, said Joseph Rannazzisi, the former head of the DEA’s Office of Diversion Control.

Some distributors ignored that guidance, Rannazzisi agreed under examination from plaintiff’s lawyer Mark Lanier, in order to pursue profits.

"The more the distributors sold, the more money they make," Lanier asked Ranazzisi in a videotaped deposition shown to the Central Islip jury that will rule on the landmark lawsuit filed by Nassau, Suffolk and New York State. "Were you aware of that?"

"Volume wise, yes," Rannazzisi responded. "Throughout the (opioid supply) chain, money is made on volume sales."

The distributors were also notified of the regulations outlined in the 1971 Controlled Substances Act during in-person meetings with DEA personnel, Rannazzisi said.

Distributors Americsource Bergen and McKesson — both former defendants dismissed from the lawsuit last week after they agreed to a $1.1 billion settlement with the counties and the state — reached settlements shortly after the DEA notified them in 2007 and 2008 that they had not followed regulations despite the guidances issued by the government.

Lawyers for the defendants suggested that the DEA was partially responsible for the opioid crisis because it issued opaque guidelines regarding the distribution of opioids or enforced the regulations in a lackluster fashion.

One attorney noted that the DEA increased the national quota for opioid manufacturing from 2005 to 2015, when Rasnazzisi led the Office of Diversion. Rannazzisi testified that he did not set the quotas.

Another lawyer suggested that Rannazzisi had become a highly paid gun for hire for governments and attorneys pursuing litigation against the opioid industry. Rannazzisi acknowledged that he has earned more than $100,000 a year as a consultant for plaintiffs’ lawyers.

The counties and the state are trying to recover millions of dollars for drug treatment, recovery and prevention, and to hold the companies responsible for the misery created by the opioid epidemic that has claimed thousands of lives on Long Island in recent years

The companies say they're not responsible for the epidemic and are being made scapegoats those who are, including illicit drug dealers, health regulators who encouraged opioid use and doctors who overprescribed painkillers.

Cardinal Health was also dismissed as a defendant along with Amerisource Bergen and McKesson last week as a result of the settlement with New York State, Nassau and Suffolk. The deal is part of a proposed $26 billion national settlement with manufacturers and distributors of opioids.

Allergan, Teva Pharmaceutical Industries and Endo International remain as defendants, along with distributor ANDA Pharmaceutical. ANDA was sued by the counties but not the state.

The trial, overseen by state Supreme Court Justice Jerry Garguilo, is being held at Touro College in Central Islip to accommodate the large number of attorneys involved in the case.

The trial resumes Monday.