1. POLITICS OF PAIN: A DECADE OF OPIOID LOBBYING AP MEMBER WEBINAR SEPTEMBER 2016

2. BEFORE WE START … Politics of Pain – Sept. 2016 Your phones are muted for the presentation Unmute to ask questions - #6 Questions can also be submitted via WebEx chat Will distribute a link to recording and a link to the website

3. POLITICS OF PAIN Politics of Pain – Sept. 2016 The Associated Press and the Center for Public Integrity teamed up to explore political contributions and lobbying by companies that make opioids and their advocacy groups. Our reporting revealed that these organizations have stood in the way of policies intended to control an epidemic of opioid abuse.

4. FIRST-TIME PARTNERSHIP Politics of Pain – Sept. 2016

5. PUBLICATION SCHEDULE Politics of Pain – Sept. 2016 This data set has been released three weeks early on an embargoed basis. The final text of both stories will be released under embargo on Sept. 12. The data embargo lifts at 12:01 a.m. on Sept. 18.

6. TODAY’S PRESENTERS Politics of Pain – Sept. 2016 Liz Essley Whyte: Center for Public Integrity State Politics Reporter Geoff Mulvihill: Associated Press State Enterprise Reporter Matt Perrone: AP Health Reporter Ben Wieder: CPI Data Journalist

7. OUR FINDINGS Politics of Pain – Sept. 2016 $889 million spent from 2006 through 2015 On average: 1,350 lobbyists at the state level each year Network of nonprofit allies, many of which receive drug company funding Opioid crisis Rampant prescribing one cause: 227 million opioid prescriptions in the U.S. in 2015 = a bottle of pills for more than 9 out of every 10 American adults 165,000 deaths since 2000

8. FEDERAL INFLUENCE Politics of Pain – Sept. 2016 Pain Care Forum: a coalition of drugmakers and dozens of non-profits funded by industry Coordinated by the chief lobbyist for Purdue Pharma, maker of OxyContin Created “echo-chamber” of pro-opioid information that influenced Congress, FDA and other federal agencies Combined PCF member lobbying spending of $662 million overwhelmed the $3 million spent by groups seeking opioid restrictions

9. STATE INFLUENCE Politics of Pain – Sept. 2016 States have moved to limit opioid overprescribing Legislation, prescriber guidelines Drug company lobbyists and advocates have pushed back 2007: Washington 2012: New Mexico American Cancer Society Cancer Action Network American Academy of Pain Management Abuse-deterrent formulations (a.k.a. Tamper- resistant opioids) More than 100 state bills so far, 81 in last 1.5 years (Source: Quorum) At least 21 with nearly identical language

10. DATA SOURCES Politics of Pain – Sept. 2016 Pain Care Forum Membership Membership directories, 2006-2013 Campaign Finance & Lobbying Data (2006-15) National Institute on Money in State Politics Center for Responsive Politics Federal Election Commission U.S. House of Representatives Office of the Clerk IRS Drug Overdose Deaths Centers for Disease Control and Prevention (ICD-10 Codes: X40-X44,X60-X64,X85,Y10-Y14) U.S. Census Bureau Opioid Prescriptions IMS Health

11. WARNINGS AND CAVEATS Politics of Pain – Sept. 2016 We can’t say how much spending is directly related to influencing opioid laws State laws differ greatly: use our proportional rankings State lobbying expenditure data aren’t comprehensive 2015 state contribution data are not complete. 2015 federal contribution data were collected differently WHAT’S NOT INCLUDED: Independent expenditures at state or federal level Contributions to state political action committees or ballot measures Contributions to politically active nonprofit organizations

12. WALK THROUGH Politics of Pain – Sept. 2016 AP Data Distribution

13. USE DATA TO LOCALIZE THE STORY Politics of Pain – Sept. 2016 Which candidates in your state received the most in contributions? How have OD deaths and prescription numbers in your state changed? Which Pain Care Forum members contributed the most? Did the number of lobbyists in your state change? Do legislators who backed or opposed opioid- restriction bills appear in the data?

14. LOCALIZE WITH SOURCES Politics of Pain – Sept. 2016 How influential were the lobbyists hired by PCF? Which topics or bills did lobbyists follow, and which lawmakers did they lobby? Was legislation pushed or written by pharmaceutical companies or other PCF members? Have Pain Care Forum advocacy groups testified on opioid issues?

15. QUESTIONS? CPI DATA JOURNALIST BEN WIEDER: Bwieder@PublicIntegrity.org CPI STATE POLITICS REPORTER LIZ WHYTE: Lwhyte@PublicIntegrity.org AP REPORTERS: Geoff Mulvihill: Gmulvihill@ap.org Matt Perrone: Mperrone@ap.org CALL CPI & LEAVE A MESSAGE: 202-750-0686