The Washington PostDemocracy Dies in Darkness

Opinion The real scandal of the opioid crisis: Crony capitalism

5-mg pills of oxycodone. (Keith Srakocic/AP)

Justice Department Inspector General Michael E. Horowitz issued a grim account this week of the Drug Enforcement Administration’s slow response to the opioid crisis and failure to use all the tools at its disposal to address the overdose epidemic.

His tale is an important acknowledgement of troubling problems at the agency, including bureaucratic infighting and stunning incompetency. But there’s an essential element of self-examination missing from this report: The opioid scandal was not just a failure of an agency; it is the consequence of an industry clawing its way into our political system and hijacking the policymaking process.

The word “scandal” here is important, as it conveys the disgraceful entanglement between regulators and the drug companies they oversee. Horowitz makes no mention of the revolving door between the agency and the industry in his report, but it spins so fast that its absence begs for a rejoinder.

The Post’s Scott Higham and Lenny Bernstein illuminated this dynamic in their 2017 exposé of the DEA’s failures in the years leading up to the opioid crisis. They detail how the DEA’s diversion control office, then led by Joe Rannazzisi and litigation department head Linden Barber, targeted powerful, multi-million-dollar wholesale distributors whose drugs were ending up on black markets, collecting nearly $425 million in fines from companies over a decade.

But in 2011, Barber left the DEA to join the law firm of Quarles & Brady, where he began representing the companies he once went after. And he wasn’t alone. Other prominent former Justice Department officials were working for pharmaceutical interests. This, as The Post reported, became a “key moment” in the government’s investigation of opioid distributors, which used their connections in the Justice Department to see if the DEA could address actions against companies in “a non-adversarial way.” (Barber declined to comment for this column.)

Rannazzisi, still head of diversion control, told The Post that Justice Department officials under pressure ordered him to back off. He refused, but over the next few years, cases at DEA headquarters languished.

We see this inertia reflected in figures included in Horowitz’s report: The number of “immediate suspension orders” issued by the agency — which prohibited companies from dispensing the painkillers — plummeted from a high of 59 in 2011 to five in 2015. Meanwhile, opioid overdoses continued to skyrocket.

Horowitz’s report describes a “toxic” relationship between diversion control staff and the agency’s legal teams, but doesn’t give much reason for that toxicity. The Post’s reporting, however, makes clear what happened: Industry interests got into the mix and mucked up investigations. As Jim Geldhof, a former DEA program manager in Detroit, told The Post regarding one distributor he was investigating: “First we got blown off by the company. And then we got blown off by our own lawyers.”

And drug interests didn’t just infiltrate the bureaucracy; it also went after Congress, where it arguably found even greater success. As the Post detailed last month, lobbyists for drug distributors recruited lawmakers, most notably then-Reps. Marsha Blackburn (R-Tenn.) and Tom Marino (R-Pa.) to push legislation that would help tie the DEA’s hands in going after companies that diverted opioid products. The legislation — later signed into law — required agents to prove that the misconduct posed an “immediate” threat to the public, a difficult standard to meet.

At one point, lobbyists provided Blackburn, now the junior senator from Tennessee, with questions to ask DEA officials during a subcommittee hearing about how they were going after the drug industry. She complied, relaying the questions verbatim. In response to The Post’s reporting, Blackburn said that her “heart breaks for those touched by the opioid crisis.”

Yes, it truly is heartbreaking, isn’t it? The DEA had all the tools it needed to take a stand against the massive influx of addictive painkillers, as Horowitz lays out. But it failed to do so, and it’s impossible not to consider the role that industry interests played in curtailing the DEA’s efforts.

There were bureaucratic reasons for the agency’s failures, too, prime among them being the DEA’s mind-boggling inability to maintain enforcement data. For example, the DEA does collect reports of suspicious orders of painkillers from the industry, but they’re reported to local DEA field offices, rather than to a database controlled by the agency’s headquarters. When Horowitz’s team attempted to find these reports, field office staff couldn’t locate them.

These are supremely frustrating errors, and the DEA must fix them. But the real emergency here is an agency that has been commandeered by the industry it’s supposed to regulate. This is a story we keep hearing over and over in Washington. If voters really want an end to crony capitalism, the DEA and the opioid industry would be a good place to start.