My DARE officer was busted for weed possession . Nothing really bad happened except they removed him from DARE . It was pretty funny . <| sep |> nah fam . they fugazi <| sep |> It ' s so good . If you ' re not listening to Oneshot ' s Campaign podcast , go out and give it a try . It ' s the best demo of the system out there . <| sep |> avowed racist Jeff SessionsReally dude ? For fuck ' s sake , get a grip . Crazies like you are why our political system is so messed up . <| sep |> Part 2 A month ' s supply of the lowest Subsys dose of 100 micrograms was $ 930 at the beginning of 2016 , up 45 % from when the drug launched the price for one of the highest doses , 800 micrograms , had more than doubled to $ 4 , 070 , according to Truven Health Analytics , which tracks prices charged to wholesalers . Some doctors wrote prescriptions for as many as four doses per day , according to government allegations and FDA adverseevent reports , which at the highest doses would be more than $ 16 , 000 per month . The FDA ' s approval of Subsys instructed doctors to start all patients at the 100 microgram dose and , if needed , to slowly increase the strength that relieved the patients ' pain . At a 2013 meeting of Insys ' board of directors , the company identified the 100 mcg starting dose of Subsys as a strategic challenge , the Illinois complaint alleges . Insys flagged prescriptions for fewer than 400 micrograms and instructed reps to work with their doctors to increase the dosages , the complaint says . Medicare spending on Subsys tripled to roughly $ 97 million in 2014 from 2013 , and soared an additional 76 % to $ 171 . 3 million last year , according to previously unpublished data provided to the Journal by the Office of Inspector General for the Department of Health and Human Services . Gavin Awerbuch , a neurologist in Saginaw , Mich . , wrote 527 Subsys prescriptions in 2014 that cost Medicare $ 3 . 7 million , according to data released this year by the Centers for Medicare and Medicaid Services . He was arrested on federal charges of healthcare fraud and distribution of controlled substances in May 2014 . In 2013 , Dr . Awerbuch ' s Subsys prescribing to Medicare patients was even more prolific , totaling $ 6 . 4 million in the year , the most in the U . S . and nearly five times as much as the nation ' s secondlargest prescriber , the data show . As with several other top Subsys prescribers , Insys had a close relationship with Dr . Awerbuch , paying him $ 90 , 000 in fees for speaking , food and travel expenses over 10 months from 2013 until his arrest , according to the federal Open Payments database , which collects data from drug and medicaldevice companies on their payments to doctors and teaching hospitals . One of Dr . Awerbuch ' s patients , identified in the government ' s criminal complaint as D . G . , was given eight Subsys prescriptions over five months , at a cost to Medicare of $ 28 , 590 . The drug was too much for D . G . , making him incoherent and unable to function , his spouse said , according to the complaint . Dr . Awerbuch continually fed D . G . pain medications , which eventually caused him to enter detoxification treatment , the spouse said , according to the complaint . Another of Dr . Awerbuch ' s patients was an undercover police officer , according to the complaint . When the officer requested OxyContin for his moderate pain , Dr . Awerbuch said the drug was highly addictive and that he would prescribe a new drug called Subsys instead . The first 30 doses would be free with a coupon , Dr . Awerbuch told the officer , according to the complaint . This month , Dr . Awerbuch pleaded guilty to illegally prescribing Subsys and defrauding a Michigan healthinsurer . He is scheduled to be sentenced in February . After Dr . Awerbuch ' s arrest , Patty Nixon began having panic attacks , often vomiting in the morning before going to work at Insys , she says . As a staff member of Insys ' reimbursement center she had worked often with Dr . Awerbuch ' s office to get his prescriptions paid for by pharmacybenefit managers , which oversee drug spending for employers and insurers . Ms . Nixon ' s job involved a lot of lying , she says . Many PBMs refused to pay for Subsys unless it was prescribed specifically for cancer pain or unless patients had tried a cheaper alternative first . So , when Ms . Nixon and other Insys employees called PBMs , they would often pretend to be from the doctors ' office that wrote the prescription and say the patient had cancer even when they didn ' t , she says . Most patients had actually been diagnosed with chronic pain , including back , neck and shoulder pain , Ms . Nixon said . Ms . Nixon says she and other employees were pressured to improve the approval rate for prescriptions by their boss , Elizabeth Gurrieri , the former Insys manager arrested in October . Ms . Gurrieri hasn ' t entered a plea . She ' d say , ' Dr . Kapoor ' s not happy , we have to get these approvals up , ' Ms . Nixon recalls . Ms . Nixon says she also testified to a federal grand jury in Massachusetts last year about her experiences at Insys . Ms . Gurrieri and other Insys managers taught reimbursementunit employees to mislead and deceive insurers regarding their employment , patient diagnoses and the medications patients had taken previously , according to a criminal complaint that accuses Ms . Gurrieri of wirefraud conspiracy . In this environment , corruption became endemic within the Reimbursement Unit , the complaint says . Ms . Gurrieri didn ' t respond to requests for comment left on her cellphone . In Alabama , Drs . Ruan and Couch made $ 40 million in illicit gains from operating what was , in essence , a pill mill , according to the government ' s April indictment . Prescribing opioids was especially profitable for the pair because many of their prescriptions were dispensed to patients by C R Pharmacy , which they coowned and operated from one of their Mobile pain clinics , the indictment says . Dr . Ruan wasn ' t only the top purchaser of fentanyl , oxycodone and morphine in Alabama in 2013 and 2014 , but also one of the most prolific purchasers of Controlled Substances in the U . S . , the indictment says . He regularly outpurchased doctors in much larger cities . Subsys was a significant part of C R ' s business . The pharmacy was the largest dispenser of Subsys to the military insurance program Tricare in 2013 , distributing 326 Subsys prescriptions at a cost of $ 1 . 6 million , or 22 % of the program ' s total spending on the drug , according to data obtained by the Journal through a Freedom of Information Act request . The pharmacy ' s Subsys billings to Tricare reached $ 1 . 8 million in 2014 . In 2014 , Insys agreed to bypass its wholesalers and sell Subsys directly to C R Pharmacy , according to people familiar with the matter . The arrangement provided the doctors with a lower price than they would get from a wholesaler , allowing them to keep a bigger share of the drug ' s retail cost when they billed insurers , the people said . Insys executives hoped the deal would give the doctors an incentive to prescribe Subsys even more , according to one of the people . The doctors sealed the deal over a dinner at Ruth ' s Chris Steak House in Mobile attended by Dr . Kapoor , former Insys Chief Executive Michael Babich and sales manager Joe Rowan , one of the people said . Through their attorneys , Dr . Couch and Dr . Ruan declined requests for interviews . Mr . Rowan declined to comment . Mr . Babich didn ' t return messages left on his cellphone . Dr . Couch ' s medical practice , including the purchase or prescription of medication , was appropriate , within the relevant guidelines and in the best interests of his patients , said his attorney Jackson Sharman , in an emailed statement . Dr . Ruan attended a dinner in Mobile at the request of an Insys sales representative that routinely called upon him , but the dinner was not arranged or requested by Dr . Ruan and did not influence the way he practiced medicine or the prescriptions he wrote for patients , said Dennis Knizley , an attorney for Dr . Ruan , in an emailed statement . C R was a reliable customer , paying its bill like a Swiss watch , right up until the Drug Enforcement Administration and Federal Bureau of Investigation raided its offices last year , one of the people said . The doctors ' trial is scheduled to begin in January , and they are expected to defend themselves against charges that include prescribing opioids that led to the deaths of four patients and carry penalties of 20 years to life in prison . The prosecution ' s witnesses may include Natalie Perhacs , a former Insys saleswoman who was arrested in February 2016 . She is cooperating with the government after she pleaded guilty in February to conspiring in a bribery scheme with the doctors , according to a person familiar with the matter . Insys hired Ms . Perhacs in 2013 on the recommendation of Dr . Ruan , who had developed a certain affection for the woman , prosecutors allege . Over the next two years , Ms . Perhacs scheduled one speaking event per week for each doctor , most of which were designed to funnel kickbacks to highvolume Subsys prescribers , she admitted in her guilty plea . Her duties also included identifying patients on low doses of Subsys and urging the doctors to prescribe higher doses , as well as securing insurance reimbursement for the doctors ' prescriptions , nearly all of which were for people without cancer , Ms . Perhacs admitted . Ms . Perhacs made more than $ 700 , 000 over two years working at Insys , with the vast majority of the money coming from commissions on Subsys prescriptions written by Dr . Couch and Dr . Ruan , she admitted . Through her attorney , Ms . Perhacs declined to comment . By the spring , insurers had started cracking down on paying for Subsys when prescribed to noncancer patients , or offlabel in industry jargon . Last year , some 80 % of new Subsys patients were prescribed the drug offlabel , before plunging to 20 % in 2016 , the person familiar with the matter said . In September , Insys announced that Dr . Kapoor would step aside as CEO and that the company had begun a search for a new chief executive . Our company remains committed to overcoming the challenges that we have faced and building shareholder value , Dr . Kapoor said in a statement announcing his planned resignation .