Efficient Prosecution of False Claims Act Violations May Help Relieve the Current Opioid Crisis

By Absil, Victor | American Journal of Law & Medicine, May 2019 | Go to article overview

Efficient Prosecution of False Claims Act Violations May Help Relieve the Current Opioid Crisis


Absil, Victor, American Journal of Law & Medicine


I. INTRODUCTION

A. Extent of Opioid Problem

Abuse of prescription opioid (“PO”) pain medications has become a substantial public health epidemic.1 The United States has the greatest number of POs on the streets of any developed nation.2 In 2015, a reported 52,404 people died from overdoses 3 with more than 33,000 of those deaths resulting from opioids.4 An estimated 2.5 million Americans have an opioid use disorder and the epidemic continues to grow.5

This article first provides a general background of the opioid epidemic by exploring some of its causes, costs on society, and solutions that federal and state governments have implemented. It is important to recognize that there are various conditions which contribute to the opioid crisis and that any proposed intervention must take this fact into account. To provide a small sense of this background, I briefly discuss one broad, ontological perspective on the opioid crisis. Seeing that the epidemic is complex, I focus on one underlying cause (with the caveat that it does not denote an isolated intervention): the over-prescription of opioids and in particular, a gap in regulations that presents an opportunity to more effectively regulate the prescription of opioids. This gap arose when the United States Department of Justice (“DOJ”) attempted to prosecute a False Claims Act (“FCA”) violation, and the willingness of Centers for Medicaid and Medicare Services (“CMS”) to pay for that claim, negated its falsity.

B. Causes and Contributions

Although humans have used opiates for thousands of years for both medicinal and recreational purposes, opioid prescriptions in the U.S. quadrupled from 1999 to 2010. Prescriptions have continued to grow, becoming ubiquitous and thousands of times stronger when combined in synthetic and semisynthetic products such as Fentanyl.6 Part of what makes the opioid epidemic so complex is that it has several causes and effects with no one-size-fits-all solution.

While this article focuses more narrowly on a particular legal context that presents an opportunity to help alleviate the opioid crisis, it is important to recognize broader forces that may contribute to the epidemic. To explore the fundamental driving force of the opioid epidemic, it is worth asking: why do humans experience substance use disorders (“SUD”) and other mental health disorders, many of which are treated with opioids, that lead to SUD?

1. Ontology

In looking perhaps as far upstream as possible, the answer may lie with the ontological structure of our very being. The neoliberal society we live in, stems from the ontological assumptions of Liberalism: that humans are self-interested, selfish, separate individuals. As a result, societal structure has developed in a such a way that reinforces those ideas—conditioning people to believe that their well-being is achieved through competitive self-interest and individualistic pursuits.7 In effect, we create our own house through self-fulfilling prophecy. When humans attempt to use social media, consumerism, and achievements in the name of progress to fill the void of interpersonal and community connection, our identities and well-being, although made up of and interdependent on the other, are built upon the idea that: as individuals, well-being is achieved through comparing oneself to others.8 Perhaps further proliferations arising from Liberal assumptions, although once useful in moving away from the Feudal system, have now become more harmful than helpful. Our societal and historical context influences how we view and treat mental illness.9 For example, medical anxiety can be a manifestation of confusion and resistance in a house that confines a person's identity to a way of being that runs against our actual ontology. Although in certain circumstances, psychotherapies such as mindfulness and cognitive behavioral therapy may obtain better results than pharmacotherapy, mental illness in the U. …

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