U.S. Attorney’s Office for the Eastern District of Wisconsin: Issue warning to opioid prescribers

Matthew D. Krueger, United States Attorney for the Eastern District of Wisconsin, and
Scott C. Blader, United States Attorney for the Western District of Wisconsin, announced today that their offices, in coordination with federal and state law enforcement agencies, have sent notification letters to numerous medical professionals around Wisconsin cautioning them about their opioid prescribing practices. These letters are part of a broader federal and state effort to reduce the number of people becoming addicted to opioids.

This week, the U.S. Attorneys have sent letters to over 180 physicians, physician
assistants, and nurse practitioners advising that a review of their prescribing practices showed that they were prescribing opioids at relatively high levels compared to other prescribers. The letters warn that these prescribing practices may be contributing to the flow of prescription opioids into illegal markets and fueling dangerous addictions. Although the letters acknowledge that the prescriptions may be medically appropriate, the letters remind the practitioners that prescribing opioids without a legitimate medical purpose could subject them to enforcement action, including criminal prosecution. The names of the practitioners will not be released.

The harm caused by opioid over-prescribing and abuse is staggering. Drug overdoses are
the leading cause of death for persons under 50 in the United States. In 2014, an average of 78 people died each day of a drug overdose. By 2017, that figure had risen to 114 deaths per day, and to more than 130 deaths per day in 2018. Nearly 70% of the more than 70,200 drug overdose deaths in 2017 involved an opioid. In Wisconsin alone, 916 people died of opioid overdoses in 2017. Opioid-related deaths now exceed automobile deaths in the state.

Of current heroin users, the majority began their descent into addiction by abusing
prescription opioids. Whether an opioid addict begins by receiving a prescription from a
physician, by sharing pills with a friend, or by exploring the family medicine cabinet, opioid
abusers eventually turn to the street drug market. In Wisconsin, opioids prevalent in street drug markets include Oxycodone and Hydrocodone diverted from clinics and pharmacies through fraudulent, reckless, and negligent over-prescribing. Addicts looking to buy prescription opioids from street drug markets increasingly receive counterfeit pills laced with fentanyl and other deadly synthetic opioids—a recent phenomenon that has fueled dramatic increases in overdose deaths.

The notification letters urge the practitioners to take stock of their prescribing practices
and to acquaint themselves with enclosed guidelines for safe and legal opioid prescribing issued by the Centers for Disease Control and Wisconsin Medical Examining Board. The letters also remind practitioners that Wisconsin law requires them to use the Wisconsin Prescription Drug Monitoring Program to assess a patient’s prescription history before prescribing narcotic drugs.

Additional information may be found here:
• CDC Guideline for Prescribing Opioids for Chronic Pain:
https://www.cdc.gov/drugoverdose/prescribing/guideline.html
• Wisconsin Medical Examining Board Opioid Prescribing Guideline:
https://dsps.wi.gov/Documents/BoardCouncils/MED/20180321MEBGuidelinesv
8.pdf

“We know that for many, addiction began with opioids prescribed by a medical
professional,” said U.S. Attorney Krueger. “By sending these letters, we are asking medical
professionals to join the fight against addiction and ensure they prescribe no more opioids than are necessary.”

“Opioid addiction has touched the lives of far too many families in our state,” said U.S.
Attorney Blader. “Medical professionals play a pivotal role in stemming the flow of legal opioids into unlawful channels. Today, we are asking the medical community to help prevent addictions before they start.”

The notification letters were sent as part of a broader effort by state and federal law
enforcement agencies to address the opioid epidemic. Efforts to combat opioid abuse are yielding results. Nationally, according to the U.S. Drug Enforcement Administration (“DEA”)’s National Prescription Audit, opioid prescriptions were down nearly 12% for the first eight months of 2018 from the same period a year earlier. In Wisconsin, the federal and state partners participating in this notification effort include the DEA, the Federal Bureau of Investigation, the U.S. Department of Health and Human Services, the U.S. Department of Defense, and the Wisconsin Department of Justice.

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