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Mar 24, 2022 61 tweets 25 min read
#WAOpioidTrial Day 46 of WA v McKesson, et al begins at this link. Defense resumes their case today. BUT FIRST. Apparently the state changed up their plan for rebuttal witnesses. Judge wants to address it today before the weekend break. He is unthrilled?

#WAOpioidTrial So that is going to be interesting this afternoon! Just after the lunch break: discussing state's changed-up plans. Hmm.

Meanwhile: defense calls an IRL witness . . but before they get on the stand, state wants to argue about it. State's mad.
Mar 23, 2022 73 tweets 30 min read
#WAOpioidTrial Day 45 of State of WA v McKesson, et al is beginning at this link for the AM session. Note that this is the last day of the trial week; no trial on Fridays. Next scheduled trial date is Monday, 3/28/2022 at 9am.

Defense resumes this AM.

#WAOpioidTrial Current housekeeping measure under discussion about how to recall DEA's Rannazzisi - state intends to recall him via Zoom to rebut, but no one seems clear on that. Defense is predicting wrapping up their case Monday or Tuesday . . maybe.
Mar 21, 2022 94 tweets 46 min read
#WAOpioidTrial Day 43 of the state of WA v McKesson, et al resumes at this link this morning. The trial began Nov. 15, 2021 and the state rested their case on day 34 (3/1/2022) and then there were motions to dismiss and FASCINATING arguments each way.

#WAOpioidTrial Defense began presenting their case the afternoon of day 36, on March 8, 2022.

We resume defense's case this morning with a live witness Dr. Chris Gilligan, an anesthesiologist out of Boston. Looks like he testified in the WV trial wvgazettemail.com/news/health/do…
Feb 17, 2022 20 tweets 5 min read
Historical data about annual prescription opioid overdose deaths in the United States has been wildly inaccurate for every year reported prior to 2018, and everything you've read about the cause of the 'overdose crisis' before then is wrong and bad: a thread. With sources. 1/20 First: Long before illicit fentanyl and the 'overprescribing of opioids' in this country, we had heroin as the primary related opioid in misuse/overdose deaths. Heroin deaths were often reported -inaccurately- as generic morphine fatalities or 'RX opioid deaths' nationwide. 2/20
Feb 10, 2022 56 tweets 26 min read
#WAOpioidTrial Day 29 is starting at this link.

OH HEY did anyone else notice that the CDC released their draft of their REVISED opioid prescribing guidelines this morning? BECAUSE THEY DID.

Any impact on the trial? Dunno.

painnewsnetwork.org/stories/2022/2…

#WAOpioidTrial Aaaand after some housekeeping measures, McKesson's defense counsel resumes their cross of Dr. Caleb Alexander ... . PROP affiliate. Good times, good times.
Feb 9, 2022 47 tweets 19 min read
#WAOpioidTrial Day 28 beginning. Random thought: Are bench trials far more stressful for judges than jury trials? In a jury trial judge has to make sure the jury hears appropriate/admissible evidence, then jury decides. Bench must do same AND then rule.?

#WAOpioidTrial Regardless, we resume with the state of WA and their witness Dr. Caleb Alexander . .. notoriously PROP-affiliated, anti-opioid, 'everyone using opioids for pain is at risk of addiction' doctor who is here with a plan to 'abate' the epidemic in WA. Sigh.
Feb 8, 2022 62 tweets 25 min read
#WAOpioidTrial Day 27 is starting at this thread. Yesterday's trial day ended w/Dr. Jakki Mohr, Marketing expert/professor/Doctorate/wizard somewhat defensively arguing about opioid manufacturing/distributing marketing practices. Cross by McKesson starts

#WAOpioidTrial McK: "All marketing activities you described were conducted for ALL products, not just opioids, correct? Many different products beyond opioids. We gotta fill pharmacy orders across all products, right?"

Mohr: Yes.
Feb 8, 2022 6 tweets 2 min read
Oregon. I'd composed a whole thing about how a Senator from Bend just introduced a new bill to shift $120million away from the state's Drug Treatment and Recovery fund and TO 'general law enforcement needs and to tackle illegal marijuana farms'. Yeah.

AWAY from drug treatment. Only it seems Sen. Tim Knopp (R, Bend) just dropped SB 1541 (which would have robbed tax revenues from last year's Measure 110) after .. presumably a cacophony of incredulous rage from all corners. He'll "revisit next year" instead. Cool cool cool.
Feb 7, 2022 46 tweets 18 min read
#WAOpioidTrial Day 26 is beginning this morning at this link.

We are starting with the arguments for/against striking all of former DEA's Ruth Carter's testimony (which was SO MANY hours). It's a defense motion to strike. Let's watch.

#WAOpioidTrial Defense says Carter missed a bunch of things, admitted on cross she'd never reviewed WA-state-specific things, etc. State is saying it was all finde etc. But the judge ... seems to be troubled about state's position on all this. Is he going to strike Carter?! 🤯
Feb 2, 2022 97 tweets 36 min read
#WAOpioidTrial Day 24 is now starting at this link. State will continue to assert their case - after some housekeeping measures to be discussed. !

#WAOpioidTrial Lots of housekeeping measures discussed. I don't think there were any rulings?

Regardless, state resumes questions with Dr. Cutler, starting with neonatal abstinence syndrome. When babies are born with addictive substances in their system. NAS for short.
Feb 1, 2022 109 tweets 44 min read
#WAOpioidTrial Day 23 is now starting. Good morning!

Here's the AM link. Also it is snowing here this morning, WTF??

#WAOpioidTrial IANAL here but it seems like the state just got admonished a bit for trying to pull some exhibit back OFF the record after defense went to the expense of reviewing; state doubles down and says they are SURE it will be in; then tried to pull it. Judge said nope.
Jan 31, 2022 38 tweets 16 min read
#WAOpioidTrial Day 22 is now starting; WA state vs. McKesson, et al can be watched here for the morning session (then the link disappears at the lunch break).

We resume with the depo from a Cardinal employee being played; most of which we saw last Thurs.

#WAOpioidTrial Once again the questions are about how the pharmaceutical distributors offered marketing/ad opportunities to the manufacturers.

Which somehow makes the distributors liable for the 'opioid crisis' which is almost exclusively polypharma heroin/fentanyl/meth. M'kay.
Jan 27, 2022 65 tweets 28 min read
#WAOpioidTrial Day 21 is now starting. Here is this morning's link, good only as long as the court is in this morning's session. It will disappear at around noon when the court adjourns for lunch.

Will the 'not-an-expert-witness' shenanigans continue? 🤔

#WAOpioidTrial Oh that is interesting - Dr. Banta-Green just closed that the attorney I assumed was 'his' is actually representing the University of Washington .. . from the WA State Attorney General's office.

Um. It's the AG who is the plaintiff. Well. That's curious.
Jan 26, 2022 83 tweets 33 min read
#WAOpioidTrial Day 20 is about to begin; here's the AM link for today.

SEVERAL big issues to be decided upon this morning by the Judge; who will have reviewed a few briefs from counsel this morning before court adjourns. WHAT will happen?? Stay tuned.

#WAOpioidTrial The first big question: Will the Judge allow these subjective surveys to be admitted - dancing around whether Dr. Banta-Green is a fact witness (which means the surveys COULD be hearsay) or if he's a dang expert (which he clearly is, but not for this trial?)
Jan 25, 2022 65 tweets 22 min read
#WAOpioidTrial resumed earlier this morning - I'm feeling bleah so I'm late on the updates. We finally, finally wrapped up testimony/cross/re-everything with Ruth Carter with only three things which stood out. Also here's the AM link until lunch. #WAOpioidTrial Also it's day 19.

1st: Counsel inquired about various things Ms. Carter had missed or excluded or got wrong in specific documents. There were quite a few things in various redirect/cross where that happened ... all of which painted the defense negatively. Hmm
Jan 24, 2022 30 tweets 10 min read
#WAOpioidTrial Day 18 has begun this morning! As suspected the unscheduled trial break was because one of the key players got COVID. It was the judge!😳 He's back now.

State has resumed their redirect of their witness, former DEA Ruth Carter.

AM link: #WAOpioidTrial We're spending a ton of time looking at distributor reports from 2008 (and such) about percentage of controlled substances ordered by specific pharmacies. With zero context about the population(s) those locations served, proximity to cancer centers, surgery, etc.
Dec 15, 2021 36 tweets 8 min read
#WAOpioidTrial Day 15 has just begun. In a confusing twist, yesterday's trial stream started on the channel about 15 mins before court started. So we NOW join today's trial in progress at THIS link, below. McKesson continuing cross with DEA's Carter.

"Has DEA ever publicly stated the appropriate amount of medically-necessary opioids needed for the nation, or for WA?"

Well no - I'm not a medical doctor. I couldn't make that calculation.

CORRECT.
Dec 14, 2021 68 tweets 14 min read
#WAOpioidTrial Day 14 has begun; this morning's link below.

We resume with former DEA unit chief Ruth Carter, state's witness, still on the stand IRL discussing various alleged issues with the 3 defendants' diversion control issues over the years.

Oh for . . . 'Cardinal stepped up reporting suspicious orders (undefined) to DEA in 2012; but if a pharmacy's order was held bc it they'd reached their order threshold, but then the threshold reset because time passed - THEY WOULD STILL SHIP NEW ORDERS.' Right. Because ....
Dec 13, 2021 59 tweets 11 min read
#WAOpioidTrial Day 13 has begun! We open this morning with state re-arguing some objections which did not go their way last week on foundation. Let's watch and see how this goes. The three prongs (apparently) are:

Authentic
Relevant
Admissible

Judge Scott has retiterated many times - and pretty much begged state to stop saying - it's not about authenticity, it's about foundation & relevance. Literally Judge said "please stop saying authenticity" AND THEN STATE SAID IT AGAIN and the Judge literally put a "wait" hand up.
Jul 17, 2021 8 tweets 2 min read
A few words about the 2005 WA State L&I opioid study - upon which the 2016 CDC Opioid RX guidelines were launched. This study was limited to a very specific group of people injured on the job in WA (as opposed to those with chronic or progressive illness). #cdcowgchat #cdcGov 1/8 There were 32 "definitely, probably" opioid-related deaths from 1996-2002 in WA, & 12 more 'possibly' or avg 7 deaths/yr. 85% were men. 69% were smokers. 8 of the deaths included illicit drugs (meth, cocaine, heroin). 5 more alcohol. In other words: Polypharma drug toxicity. 2/8
Jul 27, 2020 6 tweets 23 min read
@PainPtFightBack @Amy_L_Partridge @Danniedean5 @LelenaPeacock @speakingabtpain @headdock @SandyHiltonPT @Farmer_MindBody @j3nnac @aander1987 @Cripp4lyfe @Carrionflower1 @Seaglas15896020 @tal7291 @devrajoyPT @StefanKertesz @AmerMedicalAssn Thanks love. That was a difficult yet rewarding day for all of us, I think. Difficult because while it was nice to be with a couple hundred of 'our people' in solidarity, hearing the stories from the Sickle Cell and Adhesive Arachnoiditis communities .. . man, that was tough. @PainPtFightBack @Amy_L_Partridge @Danniedean5 @LelenaPeacock @speakingabtpain @headdock @SandyHiltonPT @Farmer_MindBody @j3nnac @aander1987 @Cripp4lyfe @Carrionflower1 @Seaglas15896020 @tal7291 @devrajoyPT @StefanKertesz @AmerMedicalAssn For those who were not there, here's a youtube video of my panel presentation:

And there is a transcript here: funchefchick.com/2018/07/12/fda…