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As the toll of the opioid epidemic grows, scores of doctors have lost their licenses and some have gone to prison. Pharmacies are being sued and shuttered. Pharmaceutical manufacturers are under investigation and face new rules from regulators. But penalties against companies that serve as middlemen between drug companies and pharmacies have been relatively scarce — until recently. In the past month, two major drug distributors, also known as wholesalers, have formally agreed to pay millions of dollars to settle claims that they failed to report suspicious orders for controlled substances to the Drug Enforcement Administration, as required by law. (Ornstein, 1/27)

A major drug company is teaming up with the state of Virginia to help curb “doctor shopping” for narcotics and overprescribing of opioids by physicians. Purdue Pharma, manufacturer of the long-acting painkiller OxyContin, said Thursday it will pay $3.1 million to upgrade the state's prescription drug monitoring program, a database that doctors and other prescribers can check before they offer a patient narcotics. The 11-year-old system is designed to curb “doctor shopping,” by showing prescribers if patients are obtaining narcotics from multiple health-care professionals. (Bernstein, 1/26)

’Tis the season for “state of the state” speeches, and governors are using their platforms to take on the opioid crisis, promise improvements in mental health care — and push back against President Trump’s plans to dismantle the Affordable Care Act. Here’s a look at some of the most notable health care themes raised by governors around the country. (Thielking, 1/27)

Gov. Dannel P. Malloy Thursday announced a series of legislative proposals intended to prevent opioid addiction and overdoses, including requiring physicians to prescribe opioids electronically rather than on paper; allowing visiting nurses to destroy unused medication; and allowing patients to add directives to their medical files indicating that they don’t want to be prescribed an opioid medication. The proposals, which Malloy announced at an event for families of people who died from drug use, also include requiring doctors to provide information about the risk of addiction when prescribing opioids, and removing legal restrictions that can prevent state agencies from sharing information that could help track trends and how resources are being used. (Levin Becker, 1/26)

Federal health officials are reporting a recent rare cluster of amnesia cases in Massachusetts in which patients also had significant brain changes that may be related to substance use. The Centers for Disease Control and Prevention says between 2012 and 2016, 14 patients were seen at Massachusetts hospitals with an uncommon amnesia that is like severe short-term memory loss. Thirteen of the 14 also had a history of drug use and their MRIs showed a significant loss of the blood to the hippocampus, the part of the brain that controls memory. (Becker ,1/26)

A state-operated drug treatment center in Fergus Falls has been sanctioned for providing false information to state regulators and allowing unqualified staff to provide treatment, among other violations of state rules. In an order issued this week, state officials said they found 28 rule violations at the 16-bed Community Addiction Recovery Enterprise (CARE) facility, which treats adolescents and adults with chemical dependency or substance abuse problems. The facility’s license has been placed on “conditional status” for two years as it operates under increased regulatory scrutiny. (Serres, 1/26)