Column: On opioid data, the devil is in the details

Published Feb. 8, 2018

The talk that U.S. Attorney General Jeff Sessions gave when he visited Tampa on Wednesday about the scourge of the opioid epidemic will resonate with the thousands of Tampa Bay area residents who have been affected, or know someone affected, by this devastating health crisis.

In his speech, Sessions highlighted law enforcement's critical work in combatting "those who act in bad faith." He mentioned going after drug dealers who peddle drugs on the streets. He talked about more novel approaches, such as targeting those who hawk their drugs on the dark web.

Of particular interest, Sessions highlighted the Department of Justice's role in investigating and prosecuting opioid-related health care fraud. He noted that the Tampa district was one of 12 across the country where an experienced prosecutor was assigned to "focus solely" on wrong-doers in the opioid health care space. As he described it, this focus on health care providers is limited solely to the nefarious individuals who act in bad faith.

In mentioning this aspect of Justice's focus, Sessions talked in detail about a new data analytics program — the Opioid Fraud and Abuse Detection Unit. In Sessions' words, he "created this unit to focus specifically on opioid-related health care fraud — using data to identify and prosecute abusers. This sort of data analytics team can tell us important information — like who is prescribing the most drugs, who is dispensing the most drugs, and whose patients are dying of overdoses."

As recently departed prosecutors at the Department of Justice here in Florida, we know firsthand that there are indeed wrong-doers out there. Indeed, we were at the forefront of using data in identifying leads and determining who might be up to no good. We routinely used data analytics to help identify potential bad actors. But, we caution our former colleagues about relying too heavily on data to identify potential wrong-doers. As in most cases, the devil lies in the details with data.

Having seen the myriad uses of data, we understand that certain physicians stand out in prescribing opioids. Many stand out for obvious and explainable reasons. So, simply looking at "who is prescribing the most drugs, (and) who is dispensing the most drugs" — is an incomplete metric. It would be little surprise, for example, that pain management doctors would be more likely to prescribe opioids than, say, podiatrists.

Likewise, looking at data in a vacuum often ignores real details. There are many more Medicare patients in the Tampa Bay area than other parts of the nation. Similarly, there are many more surgery centers in Florida than elsewhere. Thus, the fact that certain prescribers might see more Medicare patients than their peers or might be prescribing more pain medications after surgery would not necessarily be a surprise. Thus, as with every aspect of criminal prosecution, prosecutors ought to be mindful of the nuances and details.

We have no doubt that our former colleagues at Justice will continue their hard work in helping curb the opioid epidemic. And, for that, we commend them whole-heartedly. We have no doubt that the hard-working men and women in law enforcement will use all tools, including the proper use of data analytics, to solve one of our most vexing problems.

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A. Lee Bentley III is the former U.S. attorney for the Middle District of Florida. Jason Mehta was an assistant U.S. attorney in the same office. Both are now in private practice at Bradley Arant Boult Cummings in Tampa.