Not EVERYTHING Horrible And Disgusting In Government Can Be Blamed On Trump: Opioids

Tom Marino, the corrupt drug kingpin Trump wants to make Drug Czar

When you look at the list of the 30 counties with the worst prescription drug abuse problems in America-- counties where people are overdosing and dying from opioids like oxycodone, hydromorphone, codeine and fentanyl, you are also looking at a list of the counties in the Trumpist heartland that elected Trump president of the rest of us. (There is one outlier, Rio Arriba County in northern New Mexico, which voted for Clinton-- one out of 30.) This is the list of the 30 counties with the worst prescription drug problems and as you can see, 29 of them voted overwhelmingly for Señor Trumpanzee-- not 60-40... they're almost all in the 75% range. The county with the worst drug problem in America, Wyoming Co., West Virginia gave Trump 83.6% of its votes. Some Kentucky counties were even worse-- Leslie Co., for example, gave Trump 89.4% of its votes. These are the desperate and delusional people who listen to the rapacious monkey and believe every crazy, self-serving word that comes out of his filthy, unspeakably profane mouth.

1- Wyoming, WV- 83.6%
2- McDowell, WV- 74.7%
3- Boone, WV- 74.9%
4- Mingo, WV- 83.2%
5- Bell, KY- 79.9%
6- Dickenson, VA- 77.0%
7- Logan, WV- 80.1%
8- Floyd, KY- 72.5%
9- Carbon, UT- 66.3%
10- Mercer, WV- 75.8%
11- Powell, KY- 70.9%
12- Rio Arriba, NM- 24.2%
13- Russell, VA- 78.0%
14- Raleigh, WV- 74.5%
15- Cherokee, NC- 77.3%
16- Summers, WV- 71.1%
17- Johnson, KY- 84.0%
18- Tazewell, VA- 82.0%
19- Leslie, KY- 89.4%
20- Buchanan, VA- 79.1%
21- Martin, KY- 88.6%
22- Jackson, TN- 72.6%
23- Russell, KY- 84.0%
24- Wise, VA- 79.9%
25- Clay, KY- 86.6%
26- Clay, TN- 73.3%
27- Lincoln, WV- 75.2%
28- Webster, WV- 77.3%
29- Harlan, KY- 84.9%
30- Clinton, KY- 85.4%

Over 200,000 have died from a prescription opioid problem that's getting worse, not better. Yesterday, the Washington Post piublished a blockbuster piece by Scott Higham and Lenny Bernstein: The Drug Industry's Triumph Over The Tea... even before Trump was elected with the intention of taking a meat cleaver to every rule and regulation he could find that protects consumers and the public at large from the predatory corporations that fund conservatives and conservatism. What they found, in short, was "a targeted lobbying effort able to persuade the Republican-controled to weaken "the DEA’s ability to go after drug distributors, even as opioid-related deaths continue to rise... In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets."

A handful of members of Congress, allied with the nation’s major drug distributors, prevailed upon the DEA and the Justice Department to agree to a more industry-friendly law, undermining efforts to stanch the flow of pain pills, according to an investigation by the Washington Post and 60 Minutes. The DEA had opposed the effort for years.

The law was the crowning achievement of a multifaceted campaign by the drug industry to weaken aggressive DEA enforcement efforts against drug distribution companies that were supplying corrupt doctors and pharmacists who peddled narcotics to the black market. The industry worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns.

The chief advocate of the law that hobbled the DEA was Rep. Tom Marino, a Pennsylvania Republican who is now President Trump’s nominee to become the nation’s next drug czar. Marino spent years trying to move the law through Congress. It passed after Sen. Orrin G. Hatch (R-UT) negotiated a final version with the DEA.

Hatch has taken $2,767,140 from the drug sector, more than any member of Congress in history who has not run for president. So far this year he's the #1 recipient of drug industry bribes-- $310,199.

For years, some drug distributors were fined for repeatedly ignoring warnings from the DEA to shut down suspicious sales of hundreds of millions of pills, while they racked up billions of dollars in sales.

The new law makes it virtually impossible for the DEA to freeze suspicious narcotic shipments from the companies, according to internal agency and Justice Department documents and an independent assessment by the DEA’s chief administrative law judge in a soon-to-be-published law review article. That powerful tool had allowed the agency to immediately prevent drugs from reaching the street.

Political action committees representing the industry contributed at least $1.5 million to the 23 lawmakers who sponsored or co-sponsored four versions of the bill, including nearly $100,000 to Marino and $177,000 to Hatch. Overall, the drug industry spent $106 million lobbying Congress on the bill and other legislation between 2014 and 2016, according to lobbying reports.

“The drug industry, the manufacturers, wholesalers, distributors and chain drugstores, have an influence over Congress that has never been seen before,” said Joseph T. Rannazzisi, who who ran the DEA’s division responsible for regulating the drug industry and led a decade-long campaign of aggressive enforcement until he was forced out of the agency in 2015. “I mean, to get Congress to pass a bill to protect their interests in the height of an opioid epidemic just shows me how much influence they have.”

Besides the sponsors and co-sponsors of the bill, few lawmakers knew the true impact the law would have. It sailed through Congress and was passed by unanimous consent, a parliamentary procedure reserved for bills considered to be noncontroversial. The White House was equally unaware of the bill’s import when President Barack Obama signed it into law, according to interviews with former senior administration officials.

Top officials at the White House and the Justice Department have declined to discuss how the bill came to pass.

Michael Botticelli, who led the White House Office of National Drug Control Policy at the time, said neither Justice nor the DEA objected to the bill, removing a major obstacle to the president’s approval.

“We deferred to DEA, as is common practice,” he said.

The bill also was reviewed by the White House Office of Management and Budget.

“Neither the DEA nor the Justice Department informed OMB about the policy change in the bill,” a former senior OMB official with knowledge of the issue said recently. The official spoke on the condition of anonymity because of the sensitivity of internal White House deliberations.

Those refusing to comment on what happened include President Obama, former Attorney General Loretta Lynch, Rep. Marino, then top DEA official Chuck Rosenberg and DEA’s former associate chief counsel, D. Linden Barber, who, basically, wrote the bill. Cute.

With a few words, the new law changed four decades of DEA practice. Previously, the DEA could freeze drug shipments that posed an “imminent danger” to the community, giving the agency broad authority. Now, the DEA must demonstrate that a company’s actions represent “a substantial likelihood of an immediate threat,” a much higher bar.

“There’s no way that we could meet that burden, the determination that those drugs are going to be an immediate threat, because immediate, by definition, means right now,” Rannazzisi said.

Today, Rannazzisi is a consultant for a team of lawyers suing the opioid industry. Separately, 41 state attorneys general have banded together to investigate the industry. Hundreds of counties, cities and towns also are suing.

“This is an industry that’s out of control. If they don’t follow the law in drug supply, and diversion occurs, people die. That’s just it, people die,” he said. “And what they’re saying is, ‘The heck with your compliance. We’ll just get the law changed.’”

Joe Rannazzisi came to DEA headquarters as an outsider with an attitude. He worked as an agent in Detroit, where he watched prescription drugs flood small towns and cities in the Midwest.

Hundreds of millions of pain pills, such as Vicodin and oxycodone, ended up in the hands of dealers and illegal users.

Rogue doctors wrote fraudulent prescriptions for enormous numbers of pills, and complicit pharmacists filled them without question, often for cash. Internet pharmacies, supplied by drug distribution companies, allowed users to obtain drugs without seeing a doctor.

“There were just too many bad practitioners, too many bad pharmacies, and too many bad wholesalers and distributors,” Rannazzisi recalled.

Rannazzisi, a burly, tough-talking Long Islander, was assigned to head the DEA’s Office of Diversion Control. He had a law degree, a pharmacy degree and had spent years navigating the DEA’s bureaucracy.

The office was seen as a backwater operation whose 600 investigators had toiled for years over prescription drug cases with little or none of the recognition that went to those who investigated illegal street drugs like heroin or cocaine.

Rannazzisi brought an aggressive approach to the diversion control office.

The year he took over, Linden Barber was promoted to run diversion control’s litigation office, which crafted the legal arguments that supported the team. He was a former Army lawyer who served in Iraq. The cadre of attorneys who worked for him saw him as a tough litigator unafraid of an influential industry.

Barber and Rannazzisi formed a powerful combination that the drug companies would learn to fear. “Early on he did really good work,” Rannazzisi said. “He jumped into the Internet cases when he first came here.”

After shutting down the Internet pharmacies, Rannazzisi and Barber pursued the pain management clinics that replaced them and soon became as ubiquitous in South Florida as the golden arches of McDonald’s. To get there, drug dealers and users would take the “Oxy Express” down Interstate 75.

“Lines of customers coming in and going out,” said Matthew Murphy, a veteran DEA supervisor in Boston whom Rannazzisi hired to be chief of pharmaceutical investigations. “Armed guards. Vanloads of people from the Appalachia region driving down to Florida to get a prescription from a pain clinic and then get the prescription filled, going back to wherever they’re from.”

Back home, each 30-pill vial of oxycodone was worth $900.

DEA officials realized they needed a new strategy to confront this new kind of drug dealer.

“They weren’t slinging crack on the corner,” Rannazzisi said. “These were professionals who were doing it. They were just drug dealers in lab coats.”

Rather than focusing on bad doctors and pharmacists, Rannazzisi and Barber decided to target the companies feeding the pill mills: the wholesale drug distributors, some of them massive multinational corporations.

“I developed the legal framework to pursue actions against distributors,” Barber would later say. “We initiated a record number of administrative actions; the government collected record-setting civil penalties.”

Under the Controlled Substances Act of 1970, drug companies are required to report unusually large or otherwise suspicious orders. Failure to do so can result in fines and the suspension or loss of DEA registrations to manufacture or distribute narcotics.

When the DEA suspected that a company was ignoring suspicious sales, the agency filed an “order to show cause.” That gave a company at least 30 days to explain why the agency should not revoke its registration.

In the most egregious cases, the DEA employed an “immediate suspension order,” allowing the agency to lock up a distributor’s drugs. The orders instantly halted all commerce in controlled substances on the grounds that the drugs constituted an “imminent danger” to the community.

Under Rannazzisi in the mid-2000s, the DEA repeatedly warned the companies that they were shipping unusually large volumes of opioids to customers around the country. Despite the warnings, some companies continued the shipments.

The DEA soon began bringing enforcement actions against distributors. In 2007, the agency moved against McKesson, the nation’s largest drug distributor and the fifth-largest corporation in the nation, for failing to report hundreds of suspicious orders placed by Internet pharmacies. McKesson settled the case, paying a $13.2 million fine.

In 2008, Rannazzisi and Barber targeted Cardinal Health, another large drug distributor, for filling “blatantly suspicious” orders from online drugstores. Cardinal paid a $34 million fine.

The DEA would ultimately bring at least 17 cases against 13 drug distributors and one manufacturer. The government said it assessed nearly $425 million in fines over a decade. Those fines reflect only a small portion of the hundreds of billions of dollars in revenue the companies receive each year.

“It’s a cost of doing business,” Murphy said.

Along the way, Rannazzisi was making powerful enemies in the industry.

“They definitely didn’t like Joe Rannazzisi,” Murphy said. “Not at all. He wasn’t viewed as a person that they could work with. And maybe that was appropriate. He didn’t want to work with industry much.”

Rannazzisi was unmoved by their complaints.

“We’re worried about their feelings being hurt because we were doing our job?” he said. “We were making them comply. We were holding their feet to the fire.”

Murphy recalled a telling meeting with drug company representatives.

He said the president of one of the drug companies sat on the other side of the table, put his hands up and said, “ ‘You got us. What can we do to make this right?’ ” Murphy recalled.

Murphy said he had heard the same thing from drug dealers.

There was an important difference, Murphy noted.

“You know,” he said, “the heroin and cocaine traffickers didn’t have a class ring on their finger from a prestigious university.”

In 2011, Linden Barber left the DEA to join the Washington, D.C., office of the law firm Quarles & Brady. He started a practice representing drug companies. “If you have a DEA compliance issue or you’re facing a government investigation,” he said in a promotional video for the firm, “I’d be happy to hear from you.”

Barber’s move turned out to be a key moment in the struggle between drug companies and the government, but it was far from the only one. Dozens of top officials from the DEA and Justice Department have stepped through Washington’s revolving door to work for drug companies.

Two former U.S. deputy attorneys general have defended Cardinal, one of the “Big Three” companies, along with McKesson and AmerisourceBergen, that together control 85 percent of drug distribution in the United States. Jamie Gorelick, an attorney for WilmerHale, was deputy attorney general under President Bill Clinton. Craig S. Morford, Cardinal’s chief legal and compliance officer, was acting deputy attorney general under President George W. Bush.

As Rannazzisi’s investigators increased their pressure, those lawyers began to contact their former colleagues in government.

In late 2011, Morford went over Rannazzisi’s head to then-DEA Administrator Michele Leonhart as the agency again investigated Cardinal, which had sent millions of doses of oxycodone to a small number of pharmacies in Florida, including two CVS stores in Sanford.

“Michele,” Morford wrote to Leonhart in October 2011, “we are committed to working with DEA to address the challenging problem of diversion and welcome the opportunity to meet with you and your team to address these issues in a non-adversarial way.” He signed the handwritten note “Craig.”

Gorelick said in an email that she wrote to then-Deputy Attorney General James M. Cole “to ask that my client be afforded due process.” Morford did not respond to requests for comment.

Around Thanksgiving, Rannazzisi said he received a call about the Cardinal-CVS case from James H. Dinan, then-chief of the Organized Crime Drug Enforcement Task Forces program at the Justice Department. Rannazzisi said Dinan told him, “We’re getting calls from attorneys, former Justice people, that are saying you guys are doing some enforcement action.”

Four months later, Rannazzisi received a late-night call from Dinan summoning him to appear at Justice headquarters early the next morning to explain his actions in the Cardinal-CVS case to Cole.

“Please call me in the morning,” Dinan wrote, according to Rannazzisi. “I want to make double sure nothing unreversible happens before [Cole] is briefed.”

Rannazzisi was stunned. He had brought hundreds of these cases and had never been called to brief Cole, the ­second-most-powerful law enforcement official in the country.

The meeting quickly “spiraled out of control,” Rannazzisi said. “It was adversarial to say the least.”

Rannazzisi believed the message was clear: Back off.

Cole, now a lawyer in private practice, said he was not trying to pressure Rannazzisi.

“Hearing what Cardinal had to say could inform DEA of facts they may not have known,” Cole said in a statement. “I did not tell Mr. Rannazzisi how to come out on the Cardinal matter and certainly did not discourage him from going after any company in violation of any statutes or regulations,” he said.

Either way, Rannazzisi was defiant when he returned to the office from the Justice Department and sat down with his staff.

“Now this is war,” he recalled telling them. “We’re going after these people, and we’re not going to stop. We’re just going to continue to move forward. And we don’t really give a damn any more what the department wants.’”

...Behind the scenes, a major shift was taking place at DEA headquarters.

An appeals court in Washington, D.C., had been reviewing a case that Rannazzisi's investigators brought against Walgreens, alleging that some of its pharmacies in Florida were selling more than a million pain pills a year. A typical pharmacy sold 74,000.

The DEA had used an immediate suspension order against Walgreens, arguing that the drug sales constituted an “imminent danger” to the community. The DEA moved to shutter a large Walgreens distribution center in Jupiter, Fla., that supplied nearly 1,000 pharmacies along the East Coast.

Walgreens fought back.

...Geldhof, the DEA program manager in Detroit, was investigating a midsize Ohio-based drug distributor. Between 2007 and 2012, Miami-Luken had shipped 20 million doses of oxycodone and hydrocodone to pharmacies in West Virginia. About 11 million wound up in one county, Mingo, population 25,000.

Despite the rising death rate in West Virginia-- the highest in the nation-- Geldhof said his pleas in 2013 to halt Miami-Luken’s operations were ignored by the legal office at headquarters.

“First we got blown off by the company,” he said, “and then we got blown off by our own lawyers.”

Novak suspected another reason for the slowdown.

At times, he said, some of his colleagues appeared more concerned with pleasing the industry than working on behalf of the public. Some of the lawyers had simply given up fighting the industry and seemed to be preparing for a future working with the companies they were supposed to be regulating, he said.

“It was not just one person who left the office; everyone started to leave. That’s your payout. You do your time, and more and more people were auditioning for the industry. It stopped us from doing our jobs.”

The departures gave the industry an unfair advantage, Novak said.

“There was a fear,” he said. “It comes from seeing that some of the best and brightest former DEA attorneys are now on the other side and know all of the weak points. Their fingerprints are on memos and policy and emails.”

The major drug companies also brought their campaign to Capitol Hill. One of their key allies was Tom Marino, then a two-term Republican congressman from Williamsport, Pa.

Marino was a former county and federal prosecutor with deep hometown ties to a district that was reeling from the opioid epidemic.

On Feb. 18, 2014, Marino introduced the Ensuring Patient Access and Effective Drug Enforcement Act, making an effort to define what constitutes “imminent danger.” The proposal raised the DEA’s standard for suspending drug shipments by requiring that the agency establish “a significant and present risk of death or serious bodily harm that is more likely than not to occur.”

It attracted 14 Republican co-sponsors, chief among them Rep. Marsha Blackburn (R-TN), also from a region in the grip of the epidemic.

[Blackburn, a sleazy character currently running for the Senate seat Bob Corker is giving up, took $162,685 in Pharma bribes last cycle and $712,385 since first being elected in 2002.]

The DEA mobilized to defeat Marino’s measure. One internal DEA memo obtained by The Post and “60 Minutes” noted that the bill essentially eliminates the agency’s power to file immediate suspension orders of drug shipments. The new law “is fixing a problem that doesn't need fixing,” a DEA official wrote.

On April 8, 2014, with the bill stalled, Marino confronted the nation’s top law enforcement officer, Attorney General Eric H. Holder Jr., during a House Judiciary Committee hearing. Marino told Holder the DEA was treating the companies like “illicit narcotics cartels.”

“This mind-set-- it’s extremely dangerous to legitimate business,” Marino said.

He told Holder that he wanted the Justice Department to meet with industry executives. When Marino wrote to Holder three weeks later urging him to set up the meeting, the congressman added a handwritten note: “It would be great to work together on this. — Tom.”

Within the DEA and the Justice Department, Marino’s overtures to Holder set off alarms. On May 7, 2014, Matthew Strait, the DEA’s congressional liaison officer, detailed ways “to push back” on Marino’s bill, according to an email he wrote.

It was followed by a flurry of DEA memos. One said, “This bill is without basis in case law or Congressional findings.” Another said the bill “would constitute perhaps the greatest reduction in the Attorney General’s authority under the Controlled Substances Act since the Act’s passage in 1970.”

Later in May, Marino introduced a second version of his bill, with slightly altered language. Blackburn was again a co-sponsor, but this time two Democrats were on board: Rep. Peter Welch of Vermont and Rep. Judy Chu of California.

On June 4, Bill Tighe, Marino’s chief of staff, wrote to Peter Kadzik, Justice’s top congressional liaison officer, thanking him for setting up a meeting with the industry executives.

Tighe asked Kadzik to coordinate with the industry’s point person: Linden Barber.

“Linden Barber used to work for DEA,” Jill Wade Tyson, another Justice congressional liaison officer, responded in an email. “He wrote the Marino bill.”

...On July 29, the Marino bill passed the House and went to the Senate.

The Justice Department was so concerned that it took the unusual step of having Attorney General Holder publicly oppose the bill.

“A recently passed House bill would severely undermine a critical component of our efforts to prevent communities and families from falling prey to dangerous drugs,” Holder said in a July 31 news release.

The bill stalled in the Senate.

...With Rannazzisi under attack, the industry effort gained momentum. Marino introduced yet another version of his bill in the House on Jan. 22, 2015. He announced that the Energy and Commerce Committee would hold a hearing five days later.

One of the witnesses was Linden Barber.

Barber told the committee about the Walgreens case. He was still pressing the industry’s long-standing argument about the need for a clearer legal definition of the DEA’s imminent danger standard.

The case had not ended up setting a precedent that undermined the standard. Rather than take the case to trial, the company agreed to settle and pay what was then a record $80 million fine. Still, Barber argued the DEA faced legal jeopardy.

“Indeed, many of my colleagues believe that the [Walgreens] case would have resulted in a narrowing of DEA’s authority if the agency had not settled its dispute,” Barber said. “As a supporter of DEA’s mission, I urge this committee to take legislative action that clarifies the meaning of imminent danger.”

On April 21, 2015, the House took up Marino’s bill. On the floor of Congress, Marino said:

“This bill will bring much-needed clarity to critical provisions of the Controlled Substances Act. In doing so, we will ensure that the DEA’s authorities are not abused and threatened by future legal challenges; foster greater collaboration, communication and transparency between the DEA and the supply chain; create more opportunities to identify bad actors at the end of the supply chain; and, most importantly, be certain that prescriptions are accessible to patients in need.”

The House passed the bill by unanimous consent. Not one lawmaker opposed the measure.

That same day, Leonhart, who had supported Rannazzisi’s aggressive approach, announced that she was retiring as DEA administrator amid reports that some of her agents had attended sex parties funded by Colombian cocaine cartels.

For the industry and its supporters on Capitol Hill, the pieces were falling into place.

A month later, the Justice Department named a new DEA chief who said he wanted to mend the rift between the agency and the drug industry. Chuck Rosenberg was a former U.S. attorney in Virginia and Texas who had served as the chief of staff to then-FBI Director James B. Comey.

After Rosenberg came to the DEA, the agency began putting out a new message.

“Rosenberg wanted to paint a new face on the DEA for the Hill,” said Regina LaBelle, the chief of staff for the White House’s Office of National Drug Control Policy at the time. “He wanted to show them the softer side of the DEA, and he wanted to work with industry.”

In October 2015, one of the last remaining obstacles to the bill was removed. Rannazzisi was pushed aside at diversion control. With the inspector general’s investigation into his comments hanging over his head, Rannazzisi retired from the DEA after a 30-year career.

The investigation went nowhere. But, Rannazzisi said, “It destroyed me.”

By this time, Holder had left and Lynch was the attorney general. Her office informed Marino that the DEA had met with 300 industry representatives and Justice was committed to “working more closely” with the drug companies.

“We value these opportunities to communicate and work with our partners in the pharmaceutical industry,” Kadzik, Lynch’s congressional affairs chief, wrote to Marino.

At the same time, the DEA was in negotiations with Hatch's staff to amend the bill for the Senate’s consideration.

The newly proposed language required the DEA to show that a company’s conduct posed a “substantial likelihood of an immediate threat” of death, serious bodily harm or drug abuse before the agency could seek a suspension order.

...On March 17, 2016, the Senate passed the bill by unanimous consent. On April 12, the House approved the Senate version, also by unanimous consent.

...On April 19, Obama signed the bill. The White House issued a one-page news release announcing its enactment.

Marino also issued a release taking credit for the legislation.

“With this law, our drug enforcement agencies will have the necessary tools to address the issue of prescription drug abuse across the country. I applaud the hard work of my colleagues on both sides of the aisle in Congress and President Obama for realizing the importance of this legislation.”

... John Mulrooney, the chief DEA administrative law judge, has been documenting the falling number of immediate suspension orders against doctors, pharmacies and drug companies. That number has dropped from 65 in fiscal year 2011 to six so far this fiscal year, according to the DEA. Not a single order has targeted a distributor or manufacturer since late 2015, according to Mulrooney’s reports, which were obtained under the Freedom of Information Act.

Mulrooney said in his reports that the judges under him were handling so few cases at the DEA that they began hearing the cases of other federal agencies.

In his article planned for the winter issue of the Marquette Law Review, Mulrooney wrote: “If it had been the intent of Congress to completely eliminate the DEA’s ability to ever impose an immediate suspension on distributors or manufacturers, it would be difficult to conceive of a more effective vehicle for achieving that goal.”

Mulrooney’s article also criticized the law for allowing companies to submit corrective action plans before the DEA could sanction them.

He likened that provision to allowing bank robbers to “round up and return ink-stained money and agree not to rob any more banks.”

The DEA said in a statement last week that it is still pursuing reckless doctors and rogue businesses with a wide variety of tools.

“We will continue fighting the opioid crisis and continue to use all the tools at our disposal to combat this epidemic,” the statement said.

Since the DEA started to crack down on the opioid industry a decade ago, pharmaceutical companies and the law firms that represent them have hired at least 46 DEA officials-- 32 of them directly from the division. They include two officials who managed day-to-day operations; the deputy director of the division; the deputy chief of operations; and two chiefs of policy.

After nearly 30 years with the DEA, Matthew Murphy, Rannazzisi’s lieutenant, retired in 2011. He formed a drug industry consulting firm and went to work for the people he used to face across the table.

“I feel guilty,” Murphy said in a recent interview. “Because every day a lot of people die of an opioid-heroin overdose. Whether it’s a pill or heroin, people die every day because of it. And it shouldn’t be happening.”

One of the most recent departures was Jason Hadges, the senior DEA attorney overseeing pharmaceutical enforcement cases who, according to former agency supervisors and lawyers, had been demanding a higher standard of proof on cases. Hadges left the DEA in May to join the pharmaceutical and biotechnology regulatory division of Hogan Lovells, a high-powered D.C. law firm. He declined to comment, citing “client sensitivities.”

In January, Mike Gill, who had served as the chief of staff to DEA Administrator Chuck Rosenberg, left the agency to join one of the nation’s largest health-care law firms. He declined to discuss why the DEA dropped its opposition to the bill or his new job.

On Oct. 1, Rosenberg himself resigned from the DEA.

Last December, seven months after the bill became law, Marino's chief of staff took a job as a lobbyist with the National Association of Chain Drug Stores. Bill Tighe had served as Marino’s point man on the legislation. The association was a key backer of the bill. Tighe declined to comment.

In July, Inden Barber left Quarles & Brady to join Cardinal Health as the company’s chief regulatory attorney. After being the target of two DEA enforcement actions, Cardinal had become one of the biggest backers of the bill.

Marsha Blackburn, who co-sponsored the House version of the bill, received $120,000 in campaign contributions from the pharmaceutical industry. She did not respond to requests for an interview. She announced this month that she will run for the seat of Sen. Bob Corker (R-TN), who is not seeking reelection.

...Jim Geldhof, the DEA program manager in Detroit, retired from the agency at the end of 2015 after 43 years on the job. He said the companies were fully aware of their responsibilities under the law.

“When you’re selling half a million pills to some pharmacy and you’re telling me that you don’t know what the rules are for a suspicious order?” said Geldhof, who is now working as a consultant to lawyers suing the industry. “All we were looking for is a good-faith effort by these companies to do the right thing, and there was no good-faith effort. Greed always trumped compliance. It did every time. It was about money, and it’s as simple as that.”

Just before Geldhof left, his two-year quest to persuade the DEA to take action against Miami-Luken finally paid off. In November 2015, the DEA accused the company of multiple violations of the law for allegedly failing to report orders for tens of millions of pain pills from pharmacies, most of them in West Virginia. That case-- the most recent one to target a distributor-- is pending.

Of the millions of pills sent to Mingo County, many went to one pharmacy in Williamson, the county seat, population 2,924. In one month alone, Miami-Luken shipped 258,000 hydrocodone pills to the pharmacy, more than 10 times the typical amount for a West Virginia pharmacy.

The mayor of Williamson has since filed a lawsuit against Miami-Luken and other drug distributors, accusing them of flooding the city with pain pills and permitting them to saturate the black market.

“Like sharks circling their prey, multi-billion dollar companies descended upon Appalachia for the sole purpose of profiting off of the prescription drug-fueled feeding frenzy,” the lawsuit says.

Marino, now in his fourth term, continues to represent northeastern Pennsylvania and Lycoming County, population 116,000.

His nomination as drug czar, which would put him in charge of the White House Office of National Drug Control Policy, is pending.

Marino declined to be interviewed for this story, but last year he told The Post:

“We had a situation where it was just out of control because of [Rannazzisi],” Marino said. “His only mission was to get big fines. He didn’t want to [do] anything but put another notch in his belt.”

Since 2014, the year Marino first introduced his bill, 106 people have died of opioid overdoses in Lycoming County. Over six days this summer, 53 people in the county overdosed on opioids. Three of them died.

Marino's district went heavily for Trump, who beat Hillary 66.1% to 30.2%, her second worst performance in the state. The DCCC didn't bother to challenge Marino and he beat the local Democratic candidate Michael Molesevich 208,106 (70.3%) to 87,956 (29.7%). Marino raised $1,093,770 while Molesevich raised $71,898. Bernie beat Hillary in Lycoming County by 10 points in the primary and in the general, Trump pulverized her in Lycoming 71.7% to 24.4%. So far, the DCCC isn't looking at PA-10 and the two Democrats vying for the nomination, Judy Herschel and Mark McDade, have almost no resources between them. Today West Virginia Senator Joe Manchin demanded Trump pull Marino's nomination for his job as Drug Czar. He's virtually unconformable after this story. Will he be reelected? Will the DCCC have the balls to take him on? And what about Blackburn's Senate campaign? I haven't heard a peep. You?



UPDATE: Marino Is OUT

I bet someone's going to win a Pulitzer-- and not the mad Tweeter.