GAO Report Highlights Controlled Substance Disposal Struggles in Hospice

In response to Section 3223 of the SUPPORT for Patients and Communities Act, the Government Accountability Office released a 21-page report in April that outlined findings of a review conducted around controlled substance disposal in home hospice. Throughout the duration of end-of-life care, there is increased utilization of controlled substances for palliative care and pain relief, often leaving unused controlled substances unattended upon death of the beneficiary. State laws varied prior to the enactment of a SUPPORT Act provision that allowed qualified hospice programs to collet and destroy decedents remaining medications.

Six of the seven hospice programs contacted as part of the report indicated they were actively disposing of leftover controlled substances with the remaining program awaiting promulgation of state law granting such authority. The report identified several best practices for qualified hospice program disposal, including:

  • Active prescription drug counts to ensure appropriate utilization;
  • Use of lock-boxes to limit access where diversion may be suspected; and
  • Include a witness for the disposal of unused controlled substances.

Difficulties in disposal were identified around the issues of cost, lack of witness, and variances between state and federal law.

Articles & Resources

Government Accountability Office – Preventing Drug Diversion: Disposal of Controlled Substances in Home Hospice Settings (Report)

Two Cases Identified for 2021 ‘Track Three’ Opioid MDL

On Thursday, US District Judge for the Northern District of Ohio Dan Aaron Polster identified two particular cases in Lake and Trumbull Counties that would serve as additional bellwethers around claims that the pharmacy-defendants knowingly dispensed inappropriate quantities of prescription opioids and other controlled substances. Given the pending trial in Cleveland County later this year, the pharmacy defendants argued against the need for such bellwether earlier in the week.

Judge Polster’s decision to expand the bellwethers to these two counties follows an April 15th ruling on the Sixth Circuit that removed dispensing allegations from the November 2020 bellwether trial in Cleveland County resulting in the complaint focusing squarely around opioid distribution. Additional bellwethers are also set to proceed in Oklahoma and California concurrently.

Articles & Resources

Law360 – New Pharmacy Bellwether Trial Set for 2021 in Opioid MDL

Bloomberg Government – 2 More Ohio Counties to Be Subject of Another Opioid Trial

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

REMINDER: APF Sign-on Letter Opportunity: Support of Funding for SUD Programs (letter attached; please contact Liliana Coronado with questions or to add your organization’s name; deadline of May 6, 2020)

American Pharmacists Association – APhA Coronavirus Watch: Maintaining Access to Care for Patients with Chronic Pain, OUD During Pandemic

JAMA Surgery – Classification of Opioid Dependence, Abuse, or Overdose in Opioid-Naive Patients as a “Never Event”

Pew Charitable Trust – More Outpatient Treatment Needed for Opioid Use Disorder

Washington Times – Portman Says Pandemic Making Fight Against Opioids Harder

South Coast Today – Coronavirus Pandemic is Taking a Toll on Those Seeking Help for Opioid Addiction

Office of the Indiana Attorney General – AG Curtis Hill Expands EVERFI Prescription Drug Safety Course to More Indiana Counties

Federal Register Comment Request – One-Time Survey of State Agencies Regarding Use of SUD Patient Placement Criteria and Assessment Tools (Deadline of May 29, 2020)

HHS Newsroom – SAMHSA Awards Grants Expanding Community-Based Behavioral Health Services, Strengthens COVID-19 Response

White House Office of National Drug Control Policy – Free Online Prevention and Early Intervention Resources

U.S. Attorney for the Eastern District of Wisconsin – Milwaukee Pain Management Clinic and Physician Agree to Pay At Least $1.35 Million to Resolve Allegations They Violated the False Claims Act and Anti-Kickback Statute

U.S. Attorney for the Middle District of Florida – Local Pharmacist Pleads Guilty To Unlawful Distribution Of Oxycodone

U.S. Attorney for the Southern District of California – San Diego Psychiatrist Pays $145,000 to Resolve Opioid Overprescribing Investigation

This Week’s Calendar

We hope that everyone is remaining safe and healthy during the ongoing coronavirus pandemic.

Given the ongoing circumstances, there are no hearings or relevant events noticed at this time. At this point in time, the Senate will return to Washington on Monday with members of the House remaining in-district. In the instance that there are any changes to the schedule for this week, we will make additional information available.

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