In the news

TEDxTalks YouTube channel, posted Feb. 2023: Big Pharma in the Overdose Crisis: A Former Drug Rep Speaks Out | Gail Groves Scott | TEDxLancaster

In 2023-24, Health Policy Network began working with a coalition of Pennsylvania and regional advocates monitoring how millions of dollars in settlement funds from opioid litigation are being spent. 
 
Previous public health litigation funds were often spent by state and local governments in ways not benefiting the public health. For example, less than 5% of tobacco settlement funds were spent as intended to address tobacco cessation.                                                                                                    

Some PA counties, including Lancaster, did not seek public input or publish “request for proposals” before allocating millions in 2022-23 settlement funds, and tried to allocate funds outside the state guidelines, or to low-ranked or unproven interventions. HPN’s repeated advocacy efforts to the Lancaster County Commissioners resulted in policy changes in 2024 and the county rescinded some allocation requests. 

However, both Lancaster County and the state PA Opioid Trust have continued to make important decisions in secret meetings and without public input. 

 

County commissioners approve opioid settlement allocations (update), OneUnitedLancaster, May 21, 2024

 

Lancaster County to seek input from coalition on how to direct opioid settlement funding, OneUnitedLancaster, March 13, 2024

 

PA Opioid Settlement Spending to be Reviewed In Secret Spotlight PA, March 6, 2024

 

County Commissioners to Consider Adjusting Opioid Settlement Allocations, OneUnitedLancaster, March 1, 2024

 

Lancaster County Commissioners to discuss how to spend up to $2.7 million from opioid settlement, LNP, Feb. 29, 2024

 

Commissioners approve opioid settlement funds for Drug Task Force positions, OneUnitedLancaster, Aug. 30, 2023 

 

Local public health expert calls on Lancaster County commissioners to change course on opioid strategy, LNP /LancasterOnline, Aug. 3, 2023, 

 

Pa. counties face uncertainty as they grapple with how to spend opioid settlement funds Spotlight PA, and PennLive/Patriot News, 90.5 WESA  Pittsburgh, and other media outlets statewide, Aug 2-5, 2023, 

 

Drug Task Force funding at issue as Lancaster County adds nearly $1 million to its opioid settlement cache OneUnitedLancaster: Aug. 2, 2023

 

Lancaster County receives $1 million from Johnson and Johnson in opioid settlement  Abc27 TV (Harrisburg/Lancaster/York), Aug. 2, 2023 evening news

The American Public Health Association’s Public Health Newswire featured Gail’s research poster presentation on pharmaceutical marketing in a “Poster Roundup” report about their 2022 Annual Meeting in Boston. The poster was titled: “Ethical questions arising from the evolution of prescriber targeting in pharmaceutical sales.” The abstract and poster can be downloaded from the Research & Policy section of this site. Policy recommendations from the poster were highlighted in the APHA’s story by Kayla Yup, Nov.6, 2022.

Gail commented on overdose data gaps for a story in The Morning Call: “State, federal estimates of Pennsylvania deaths in overdose crisis are far apart” by Ford Turner, February 2022.  “It is disturbing we don’t have better data on drug overdose deaths. Many legislators were demanding better data on COVID deaths and mortality. This information is critical to addressing the public health problem and it needs to be better.”

In an interview with Fox43-TV, prior to the unanimous Senate Judiciary Committee vote of support for SB 845, the bill to decriminalize Fentanyl Test Strips, Gail said that fentanyl contamination can be deadly to even the casual user “who may be experimenting with a drug, and only use once.” Reporter Matt Maisel described the bill as “what most state legislators call a ‘good government bill, closing a loophole, or fixing an issue that everyone agrees on.” The bill has passed to the full Senate, but its House counterpart HB 1393 (Struzzi) was not yet brought to the floor for a similar vote. Fentanyl test strips, currently a crime in Pennsylvania, could soon be legalized, Fox 43, February 2022

In coverage of the House Judiciary Committee hearing, Gail Scott was quoted saying that legalizing fentanyl test-strips is not “enabling.” Such “harm reduction” approaches “enabled my child to stay alive long enough to get into treatment,” Scott said. ‘It would literally save lives’: Strong support in Harrisburg for letting drug users test for Fentanyl, by Ford Turner, The Morning Call, January 2022

Gail was interviewed about her former job as a sales representative for Purdue Pharma as well as her current research on pharma marketing, for an investigative report in The Chronicle of Philanthropy by Jim Rendon (Jan. 2022): “How Nonprofits Helped Fuel the Opioid Crisis.” The report describes how drugmakers donated millions to patient-advocacy and physicians’ groups in order to grow the market for opioid pain medications. Gail described how Purdue Pharma sales representatives used guidelines from the nonprofit American Pain Society, distributing their industry-funded booklets, which downplayed the risk of addiction while promoting the use of opioids for more types of chronic pain: “You’re trying to educate physicians, and it does appear more credible to give them something from a third party,” she said. The report concludes by citing Gail on how addiction treatment manufacturers have followed the same playbook in recent years by funding patient advocacy and other nonprofit groups that “advance their agenda” to boost drug sales and profits. 

Gail was invited to write a column in LNP, Lancaster’s daily paper, advocating for a Public Health Department in Lancaster County: “Fixing our inadequate public health system.” She noted that discussion about the local public health structure was focused on the COVID-19 pandemic, but we should also include the other public health disaster–our drug overdose crisis which has killed more than 840,00 Americans: “The Centers for Disease Control and Prevention reported a 22% increase in Pennsylvania deaths in the most recent 12-month provisional data. Preventable deaths. All public health policy failures.” LNP/ Lancaster Online, May 2, 2021

In “Commissioners to vote on body scanner for Lancaster County Prison” Carter Walker reported on the county’s decision to buy an X-ray body scanner to use to try to stop contraband from being smuggled into the county’s jail. His story described Gail raising questions “about how radiation from the scanner would affect the health of inmates, especially those with pre-existing conditions” and asking for prison officials to be “transparent with how inmates will be scanned and with what frequency,” In response, a jail official stated that they were working on a safety policy. LNP/ Lancaster Online, March 13, 2019

An investigative report by Lindsey Blest in LNP looked at data on how South-Central PA prosecutors have become outliers in charging people with homicide in connection to accidental overdose deaths. “Dozens of people have been charged with delivering fatal drugs in Lancaster County since 2012. Is it a solution to the opioid crisis?” The story quotes Gail arguing against the policy, which has been shown to deter people from calling 911. “We’re ramping up the criminalization of drug overdoses here. That’s the opposite of the public health approach,” she said. Groves Scott said preventing overdose deaths using naloxone is a vital first step followed by increasing access to treatment. “The bottom line is getting … [people] to believe that they can get better and there’s help for them.” LNP/ Lancaster Online, March 4, 2019

In “Sublocade: Why a Placebo Arm?” by Alison Knopf, Gail described how as a sales representative for Reckitt Benckiser Pharmaceuticals, one of the study reprints she distributed showed a high mortality rate in a control group that did not get medication treatment: “I often explained about the ethics of the trial design as a Suboxone rep when I used that reprint on calls, and pointed out the poor outcomes for the patients not taking buprenorphine”. Gail argued that it is unethical to have a placebo arm (vs. an active comparator, i.e. an FDA-approved medication) in an addiction medication study, therefore denying access to a proven treatment. This was the design of a clinical trial for Sublocade, Indivior’s new injectable form of buprenorphine, even though competitor companies were using active comparators. “The use of a placebo-controlled arm in the Sublocade trial 15 years later is even more unethical, in my opinion, considering the much greater evidence base today about the high mortality for opioid use disorder patients in treatment without pharmacotherapy.” Alcoholism & Drug Abuse Weekly, March 08, 2019. https://doi.org/10.1002/adaw.32287

 

An article in Addiction Treatment Forum reviewed Gail’s policy proposal to modify the regulations for dispensing buprenorphine in hospitals. Gail recommended that a DEA regulation that restricts buprenorphine dispensing in hospitals for acute withdrawal to only 3 days should be changed to allow longer prescriptions. This would allow acute provision of medication to bridge patients to outpatient appointments or inpatient admission. The “Three-Day Rule” Needs To Be Extended to Allow Longer Treatment With Methadone or Buprenorphine / Addiction Treatment Forum, January 2019

LNP reported on a course Gail organized at Lancaster General Hospital in April 2018 when she was managing the University of the Sciences’ cannabis continuing education, for the Substance Use Disorders Institute. Held at the request of the local Hospice and Community Care nonprofit, the training attracted 85 physicians and clinical staff. The article quoted Gail on how LGHl was the first hospital in Pennsylvania to hold this PA Department of Health-approved 4-hour medical marijuana certification course at its facility.  Lancaster County Doctors Attend Medical Marijuana Course, LNP/ Lancaster Online, April 2018 

In “Transparency Needed in Opioid Marketing, Litigation Shows” Gail described her shock when she heard that sales representatives for Insys Therapeutics were bribing physicians to prescribe their fentanyl pain medication, Subsys. Gail noted that when she worked as a pharmaceutical sales person, she thought that most companies were trying to improve their regulatory compliance. “After all that had happened, I couldn’t understand how this could be — that there was a company behaving so badly.” Alcoholism & Drug Abuse Weekly, pp. 4-5, June 2018, https://doi.org/10.1002/adaw.31995

Gail was asked to comment on Purdue Pharma’s announcement that it was no longer promoting opioids to prescribers, in the wake of criticism of its marketing. Gail said: “OxyContin won’t benefit from any more field representation–it’s already number one in that class. Providers who have 20 years of advice prescribing it don’t need any new advice.” Gail went on to say that although she believed the decision was made because it was a smart move from a business perspective, that in her view, companies should reduce their marketing to physicians, because of the inherent conflicts of interest. The story also included Gail’s comments on illegal marketing by pharmaceutical companies. Alison Knopf, “Purdue to Stop Promoting Opioids to Prescribers”, Alcoholism & Drug Abuse Weekly, February 19, 2018, https://onlinelibrary.wiley.com/doi/10.1002/adaw.31861

Several publications wrote about Gov. Tom Wolf of Pennsylvania’s early 2018 statewide disaster declaration,  which waived some regulations around opioid use disorder pharmacotherapies to expedite care in the wake of the overdose epidemic. A national addiction policy weekly quoted Gail saying that: “If this emergency declaration will be a mechanism to reduce these barriers for good, it will be a big win for our providers and for patients.” However, she said she believed the disaster declaration could have gone further, calling it “a disappointment to those who were hoping it would bring real change.” Both the national policy coverage, and the local newspaper story, noted that Gail said real reform would include: decriminalizing syringe service programs, eliminating prior authorization for buprenorphine in the state’s Medicaid program, funding community-level recovery supports “that engage users where they are” and eliminating discrimination in housing, justice and treatment programs that do not utilize medications. “Pennsylvania Streamlines Methadone and Bupe Treatment” by Alison Knopf. Alcoholism & Drug Abuse Weekly, p. 6-7, January 2018, https://doi.org/10.1002/adaw.31821

Also “Lancaster County reacts to governor’s declaration of ‘state of emergency’ in fight against heroin, opioid overdoses” by Tom Knapp, LNP/ Lancaster Online, Jan. 10. 2018

Gail was quoted in a national magazine: “The Latest Dangerous Drug Trend Doesn’t Actually Exist” about a misconception that injection drug users have “Narcan parties” and how the rumors started because of a real public health concept known as “risk compensation.” The story notes that the use of naloxone has not been shown to drive riskier drug use, but even if we found that in some individual cases it did, we have much stronger evidence that the overdose reversal drug is key to reducing deaths in the overall population. She made an analogy to explain that even though “somebody might drive faster because they have a seatbelt on, [that] generally does not outweigh the health benefit of everyone having seatbelts.”.Troy Farah for The Outline, July 2017

The University of the Sciences’ alumni magazine’s cover story in Summer 2017, was on the education and policy work of faculty and staff around the opioid crisis, and it highlighted Gail’s work as an addiction policy fellow. In an article titled “Bridging Lessons from the Front Lines to the Classroom”, the magazine quoted Gail and two faculty members on their experience serving on subcommittees of Philadelphia Mayor Kenney’s Task Force to Combat the Opioid Epidemic. The article described Gail as “leading the University’s addiction studies” by spearheading the launch of the University’s Substance Use Disorders Institute. A second article: “Making the Connections: Opioid Use” was about a public symposium that Gail organized, for which she moderated a panel of local and state public health officials and health policy advocates. USciences Alumni Magazine, The Bulletin, vol. 104, no. 2