Confronting opioids

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President Donald Trump holds a pen up after signing bipartisan legislation to confront the opioid crisis in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

President Donald Trump holds a pen up after signing bipartisan legislation to confront the opioid crisis in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

President Donald Trump listens as first lady Melania Trump speaks during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

DeeDee Wheeler, a recovering addict that has been clean for over three years, shakes hands with President Donald Trump during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

Trump signs bipartisan measure to confront opioid crisis


Associated Press

Thursday, October 25

WASHINGTON (AP) — President Donald Trump pledged on Wednesday to put an “extremely big dent” in the scourge of drug addiction in America as he signed legislation intended to help tackle the opioid crisis, the deadliest epidemic of overdoses in the country’s history.

Nearly 48,000 people died last year from overdoses involving opioids. Overall, U.S. drug overdose deaths have started to level off, but Health and Human Services Secretary Alex Azar says it’s too soon to declare victory.

The legislation will add treatment options and get the U.S. Postal Service to screen overseas packages for a synthetic form of opioids called fentanyl that are being shipped largely from China.

The measure mandates advance electronic data on all international packages, including those delivered by the Postal Service, and set deadlines for the screening to be put into place by the Department of Homeland Security, Customs and Border Protection and the Postal Service.

The Obama administration secured a commitment to expand treatment and Congress provided $1 billion in grants to states. Trump declared the opioid epidemic a national emergency and two major funding bills have passed under his watch.

“My administration has also launched an unprecedented effort to target drug dealers, traffickers and smuggler,” Trump said. “We are shutting down online networks, cracking down on international shipments and going after foreign traffickers like never before.”

The White House says the Justice Department has shuttered a large “Darknet” distributor of drugs, and in August indicted two Chinese nationals accused of manufacturing the shipping fentanyl and 250 other drugs to at least 25 countries and 37 states.

Fentanyl is inexpensive but some 50 times more powerful than heroin, according to Sen. Rob Portman, R-Ohio., who was recognized at the East Room event along with other lawmakers instrumental in getting the bill passed.

Despite Trump’s calls for using the death penalty against major drug dealers, his administration has built on the treatment approach that Obama favored.

The legislation covers not only opioids but also any kind of substance abuse. It expands Americans’ access to treatment and changes the law that prohibited Medicaid from reimbursing residential treatment at certain facilities with more than 16 beds.

It includes $60 million for babies born dependent on these drugs and authorizes a variety of programs, such as drug courts that work to get offenders into treatment instead of behind bars.

“Together we are going to end the scourge of drug addiction in America,” Trump said. “We are going to end it or we are going to at least put an extremely big dent in this terrible problem.”

Trump also recognized more than 20 corporations for private sector commitments to fight the opioid crisis.

Online: Health and Human Services Department site on opioids:

Man accused of selling drugs to billionaire’s son charged

CLEVELAND (AP) — A man who authorities say sold a deadly mixture of drugs to the son of a Greek billionaire in Cleveland has been indicted in federal court. reports 35-year-old Terry Lee Christian is charged with selling 34-year-old Sokratis S. Kokkalis a mix of heroin, cocaine and fentanyl outside JACK Cleveland Casino in July. Kokkalis was found dead in a downtown hotel room from a fatal overdose.

Kokkalis was in Cleveland for a gambling conference. The criminal complaint says surveillance footage shows Christian selling drugs to Kokkalis.

Kokkalis’ father, Socrates P. Kokkalis, is the founder of a Greek telecommunications company and chairman of the Greek soccer team, Olympiacos F.C. His son was the team’s vice president.

A message seeking comment was left with Christian’s public defender Wednesday.

Information from:,

The Conversation: Roundup weed killer lawsuit hits a snag, but Monsanto is not off the hook

October 26, 2018

Author: Richard G. “Bugs” Stevens, Professor, School of Medicine, University of Connecticut

Disclosure statement: Richard G. “Bugs” Stevens does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Partners: University of Connecticut provides funding as a member of The Conversation US.

On Aug. 10, 2018, a San Francisco jury handed down a US$289 million award to Dewayne Johnson, a groundskeeper who is dying of non-Hodgkin lymphoma. Johnson sued Monsanto, the maker of the weed killer Roundup, claiming that glyphosate – the active ingredient in Roundup – caused his cancer. The jury awarded Johnson $39 million in compensatory damages and $250 million dollars in punitive damages.

Now, in response to a request from Monsanto for a new trial, Superior Court Judge Suzanne Bolanos has partially overturned that verdict. Judge Bolanos let stand the jury’s finding that Roundup caused Johnson’s cancer, but decided that the punitive damage award was too high, and offered Johnson two alternatives: accept $39 million in punitive damages ($78 million in total), or submit to a new trial on the punitive damages. The compensatory damages of $39 million would remain intact either way.

This new twist in the case highlights key questions in tort litigation: What is the meaning of “proof of causation,” and what constitutes fair compensation once “cause” has been “proven”? My field, cancer epidemiology, has developed ways to think about causation, but we still struggle with defining it for individual patients. Whenever epidemiology is used in court, an added layer of complexity comes from issues of human suffering and fairness to the individual plaintiff.

In 2017, 22 women and their families were awarded $4.7 billion in a lawsuit claiming that talcum powder made by Johnson & Johnson contained asbestos and gave the women ovarian cancer.

A cascade of syllogisms

There are several crucial steps in product liability litigation, each of which depends on a syllogism. If a person is injured, then there must be a cause. If the cause was a company’s product, then that company should pay compensation. If the company knew, or had a good reason to suspect, that the product was dangerous, then the company should be punished and required to pay punitive monetary damages.

Glyphosate was classified as a probable human carcinogen in 2015 by the International Agency for Research on Cancer (IARC), which is part of the World Health Organization. That classification was one cornerstone of Johnson’s lawsuit. The other cornerstone was a series of internal Monsanto documents which seemingly implied that the company knew or suspected that glyphosate was dangerous.

The jury was persuaded that Johnson’s cancer was caused by Roundup, and that Monsanto had known it was dangerous for a long time. Each of these decisions, of course, was a matter of opinion. That’s how the legal system works to “prove” cause and effect. Some jurors felt so strongly about their verdict that they wrote to Judge Bolanos urging her not to overturn it.

Probability of causation in cancer cases

The legal claims against Roundup are torts – cases that one private party brings against another seeking compensation for some kind of harm. Under current tort law, plaintiffs must prove an action by the defendant caused them a specific harm.

For example, if a new automobile is sold with faulty brakes and someone is injured as a result, specific causation is easy to determine, and the car’s manufacturer is liable for compensatory damages. If the manufacturer knew the brakes were faulty, then punitive damages would also be awarded.

But it is much more difficult to determine a specific cause for a cancer diagnosis. Heavy smoking greatly increases risk of lung cancer, but it is impossible to prove that an individual smoker’s lung cancer was due to smoking, since even lifelong nonsmokers sometimes get lung cancer. There is no reliable laboratory test to identify the specific cause of an individual cancer.

In such cases, the question becomes the “risk of harm,” as opposed to “specific causation.”

In the scientific world, the idea of “risk of harm” is analogous to the concept of “probability of causation,” or PC, which the National Cancer Institute has developed over the last several decades to assess cancer risks associated with exposure to ionizing radiation. These risk estimates are based in part on the long-term risk of cancer in survivors of the atomic bombings in Hiroshima and Nagasaki.

PC values are used in determining worker’s compensation awards. If a worker at a nuclear power plant develops leukemia and his or her cumulative radiation exposure over the years as measured by a badge dosimeter exceeds a certain threshold, then the worker’s leukemia is deemed probably to be the result of radiation exposure, and compensation is warranted.

This approach could be useful in product liability lawsuits when the harm is development of cancer or some other terrible chronic disease for which “specific causation” is unknowable. It would involve two important steps. First, jurors would need to understand the risk analysis itself: What data are used, what assumptions are made, and what statistical modeling was applied?

If the analysis is deemed to be credible, the next thorny issue is determining what threshold should trigger damage awards. If juries believe there was a 10 percent chance that a product gave a plaintiff cancer, should the manufacturer pay? This seems too low, but requiring 99 percent certainty seems unattainable. Perhaps a reasonable threshold would be a 51 percent chance – in other words, more likely than not.

In praise of litigation

Tort litigation today does not require juries to meet such precise standards. Nonetheless, despite its inefficiencies and occasional injustices, I believe it is an important part of American society, and has often led to changes in policy and regulations that have benefited the public.

One well-known example is the case of groundwater contamination and leukemia in the town of Woburn, Massachusetts, in the mid-1980s. Residents sued two large corporations for groundwater contamination from their operations, which they asserted had caused several cases of leukemia. The lawsuit resulted in a book and movie, both titled “A Civil Action.” It also resulted in an Environmental Protection Agency investigation and then prosecution, including what was at the time the largest settlement paid in the history of the Superfund program in New England.

As the Woburn case demonstrated, tort litigation can be a costly and time-consuming process. Many lawsuits are frivolous, which compounds the cost. The system can certainly be improved, and efforts to do so are ongoing.

But in the end, tort litigation is one of the few avenues available for compensation from large corporations that do the wrong thing and hurt people. And sometimes it can lead to real changes in rules and regulations that will protect the public in general.

It’s too soon to tell whether lawsuits against Monsanto will have limited impact or radically change how Roundup is marketed and used. But the twists and turns in Dewayne Johnson’s case have raised important questions about risk, causation and liability. And this latest ruling suggests that they will not be resolved anytime soon.

Presidential Nuclear Nonsense

By John LaForge

The Reagan Administration’s 1980s crazy talk of “winning” nuclear war with “only” 20 million US dead produced a lot of anti-nuclear activism — all over the world. In Europe, hundreds of thousands marched against the placement of US Cruise and Pershing II missiles in NATO countries.

Fear of nuclear war and anger over presidential ignorance of it also produced the 1987 Intermediate-range Nuclear Forces Treaty, or INF. The treaty banned nuclear-armed missiles in Europe with a range of 270-to-2970 miles. About 2,700 missiles were destroyed by 1991, a deal that weapons salesmen like President !#&$! don’t like.

What the British, German, Dutch and Belgian marching masses were so alarmed about was NATO’s plan to destroy Europe in order to save it. Former West German Chancellor Helmut Schmidt explained it this way: “So-called ‘flexible response’ …. means that the West … says to the Soviet Union: ‘We threaten you with a military defense strategy which foresees the early use of so-called tactical nuclear weapons.’ That means for the Germans that the West in its self-defense would destroy Germany.”

Schmidt’s description was no exaggeration. In an October 5, 2018 report by the Congressional Research Service, “flexible response” was explained similarly. “NATO’s strategy of ‘flexible response’… is designed,” the C.R.S. wrote, “to allow NATO to … be the first to use nuclear weapons in a conflict, with the intent of slowing or stopping [opponents] if they … advanced into Western Europe.”

Now, President !#&$! says he will withdraw from the INF treaty because he claims Russia is in violation of it. Russia denies this, noting that research and development is not banned, that its new land-based cruise missile “fully complies” with the treaty’s requirements.

These questions could all be settled with negotiations, but President !#&$! wants to get contracts for new missiles signed the and the gusher of military spending pumping, so that electoral votes are bought and paid for this year, and in 2020. Last Feb. 12, the Prez boasted, “We’re increasing arsenals of virtually every weapon. If they’re not going to stop, we’re going to be so far ahead of anybody else in nuclear like you’ve never seen before.” Never mind that the president cannot speak English; he and Congress are handing hundreds of billions of your tax dollars to their friends.

· Boeing took down $14.6 billion for the year 2015, and last February, won a $6.5 billion contract from the Missile Defense Agency to complete an “a new missile field with 20 additional” ground-based interceptor rockets at Fort Greely, Alaska, according to the Washington Post. While missile defense systems have never worked, the Pentagon said the total Boeing contract would reach $12.6 billion through 2023.

· Lockheed Martin, the world’s biggest arms merchant, is buried in money with $29.4 billion coming to it in 2015 under 66,000 contracts.

· Raytheon was obligated to get $12.3 billion that year, including $31.8 million 464 Excalibur cannon-fired munitions that will also be sold to Sweden, Canada, Australia and the Netherlands.

· General Dynamics drank up $11.8 billion building warships.

· Northrop Grumman took down $9.5 billion, including the year’s portion of the (projected) $55 billion Long-Range Strike Bomber.

· United Technologies nailed a cool $1 billion for a few more F-35 fighter jet engines, but was obligated to get $6.6 billion for its 24,000 contracts in 2015.

With the public demanding affordable health care, better public schools, energy efficient cars, mass transit, and safe energy production, weapons builders could instead be putting their engineering expertise to good use. Enough of our wartime frenzy of bomb-building waste and fraud may again move millions to demand a reversal.

Martin Schulz, leader of the German Social Democrats who campaigned against Angela Merkel last year, was being reasonable in September 2017 when he said, “As chancellor, I will commit Germany to having the nuclear weapons stationed here withdrawn from our country. The cap on nuclear weapons in our country must be zero.”

John LaForge, syndicated by PeaceVoice, is Co-director of Nukewatch, a peace and environmental justice group in Wisconsin, and is co-editor with Arianne Peterson of Nuclear Heartland, Revised: A Guide to the 450 Land-Based Missiles of the United States.

What Does the Common Law Know About Exxon?

By Erin Mundahl

For over a year, more than a dozen state and local governments have been suing ExxonMobil, Shell and other fossil fuel companies over alleged damages associated with global warming. So far, they haven’t been successful, but they are pressing forward on a new approach relying on common law that could eventually prevail.

In a discussion sponsored by the Federalist Society, legal scholars debated the common law legal theories behind the suits, the role of the various branches of government and the applicability of the common law theory of nuisance.

These climate change lawsuits have all been structured around variations of the common law theory of nuisance, which their advocates argue gives state and local governments the ability to sue energy companies for damages associated with their conduct. In this case, that would be the sale of the fossil fuels that consumers later burned, exacerbating the harms of global warming.

According to the academics at the Federalist Society, this is a novel — though flawed — legal approach.

For one thing, the theory of public nuisance remains relatively undefined. “Public nuisance itself as a doctrine has never had a well developed definition,” said Professor Donald Kochan, associate dean of research and faculty development at Chapman University. “It has never been robust in the common law, which we should keep in mind when a non-robust standard in the common law is being asked to encompass these unprecedented claims.”

The cases have relied on the common law to fill in for a space where, the plaintiffs argue, the federal government has not exercised its regulatory authority. The common law theories they invoke have generally been applied to specific harms with identifiable contributors. However, the current lawsuits have attempted to use them to go after the companies that sold oil and gas, rather than the consumers who purchased and burned the fuels.

This is an expansion of the legal doctrine that says that liability falls to the person responsible for the action itself, in this case, the end consumer who burned the fossil fuels. Trying to use the common law definition of liability to sue energy companies takes the law in a new direction.

“There was a settled expectation that this was a legit business and now you are trying to rewrite history,” Kochan said.

New cases are trying to trump up the wrongful conduct element of a negligence suit, but in the end the issue boils down to allegations that the companies knew about climate change and continued to sell fossil fuels rather than facilitate the transition to a renewable economy.

Phil Goldberg, director of the Progressive Policy Institute Center for Civil Justice and managing partner at Shook, Hardy & Bacon, believes these lawsuits are purely symbolic in nature, meant more to appeal to media attention than to address the harms of global warming.

“The pleadings were intentionally written like press releases,” he said.

He wonders if the mere act of selling a gallon of gasoline is necessarily a tort. So far, courts have not deemed purchasing fuel to be an unreasonable interference of public rights. This mean that one of the foundations of the public nuisance suit, at the least, rests on untested legal grounds.

Before the details of public nuisance can be debated, however, the court must first decide if the common law standard is in fact appropriate. And in California, climate lawsuits have been stalled by a debate over whether state or federal courts have jurisdiction.

The legal theory of displacement stipulates that if the federal government, or a federal agency, regulates a particular issue, the courts are pushed out. This pushing out would also apply to the common law. Since the federal government, through the Environmental Protection Agency, has been regulating air pollution since the 1970s, an argument could be made that regulation of carbon-dioxide emissions and their effects is bound by federal legislation and not common law.

However, since the Clean Power Plan has been stayed by federal court, the issue becomes more complicated. For instance, if President Trump were to repeal the Clean Power Plan, it could reopen legal space for states to regulate the issue.

“If Trump leaves a gap, does that make some of the claims of the common law active again, since they are no longer displaced by the EPA?” said Professor Steven Ferrey of the Suffolk University Law School.

The underlying uncertainty of the common law doctrine shows the key gamble of the suits. In filing them, environmentalists are betting that judges will agree with their interpretation of the evidence supporting man-made global warming and the steps that should be taken to combat it.

As one of the speakers reminded the group, this is far from certain and the cases could end up backfiring on environmentalists.

“What if these courts decided to rule that climate change was fake, that climate change was not real. Would we trust judges to be making that determination?” asked Kochan. “We would close out the political debate by making a political decision that we are supposed to respect somehow, (that) there is no climate science that can justify regulation. If that were the case, then people wouldn’t be trusting judges. Yet that is a perfectly possible outcome when you put things in the hands of judges.”

The climate change cases are, so far, a large uncertainty. While they could cost oil companies hundreds of millions of dollars, they could also close the door on climate litigation by ruling against environmentalists. Right now they may be another example of the adage: Good cases make bad law.


Erin Mundahl is a reporter with

President Donald Trump holds a pen up after signing bipartisan legislation to confront the opioid crisis in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci) Donald Trump holds a pen up after signing bipartisan legislation to confront the opioid crisis in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

President Donald Trump listens as first lady Melania Trump speaks during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci) Donald Trump listens as first lady Melania Trump speaks during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)

DeeDee Wheeler, a recovering addict that has been clean for over three years, shakes hands with President Donald Trump during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci) Wheeler, a recovering addict that has been clean for over three years, shakes hands with President Donald Trump during an event on the opioid crisis, in the East Room of the White House, Wednesday, Oct. 24, 2018, in Washington. (AP Photo/Evan Vucci)
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