Throwaway account. I could write a book about this and will do my best to keep it short but it wont be.
Quickly about myself, I am not a drinker, it makes me sick, not because I am a teetotaler. I smoke a ton of pot, it levels my mood. I tried to drink along with my wife when we first were dating and we both got to witness me just being sick more often than not.
At the time my wife drank a lot. I didn't know so much at first. But within the first month I thought there might be a problem with the amount of what I would think is healthy. It was weird having a drunk partner when your cold sober all the time too.
We are both in our 40's now. 30's then. We have been married and together for almost a decade. It is a first marriage for both of us. I am self employed and I don't make much profit, but I pay for our housing and (most) of the utilities.
She is a Family Nurse Practitioner and makes decent money. She has 2 DUI's on her record, and the last one put her license in jeopardy with the nursing board. Fortunately our state is not like a few others and she can still work unencumbered. There was a potential third DUI that would have resulted in some real jail time, but for the grace of god the state did not prosecute. The first DUI was years before she met me. The second DUI happened while we were dating.
I had the most unfortunate understanding on how to acquire all the party drugs. I was very naïve. She asked me to get her some Xanax, and I had never done MDMA before. In addition I stupidly got some Tramadol for my chronic back pain. I didn't really know what xanax was or did or what it made people act like. Especially when they started drinking on top of it. She was about to leave for work totally plastered. As a nurse no less. I tried my best to stop her, we had a fight and unless I wanted to escalate it to some kind of physical level I was powerless. Some random citizen on the road called in to 911 about her drunken driving, and she was arrested for DUI shortly after. After a few more weeks of just craziness from this girl I decide I'm just about over it. I have everything I care about and drive to my place with the intention of never really returning to her place. I got a call hours after returning home with her sobbing about how she doesn't want to split but its barely intelligible through the xanax and alcohol. Then about twenty minutes later, I get a call from her about how she got in an accident. The phone gets put down. I hear police officers talking amongst themselves. They are trying to determine what she is on and why she is acting the way she is acting. One of them mentions that it might be xanax. That's about when the phone disconnected. They take her in but don't formally charge her with anything and ask her to pee in a cup. She thankfully is smart enough to know to say no, and she did. So the state didn't have much evidence for this one and dropped it. Both of our lives would have been very different otherwise from this point on.
The months following this we knew xanax was a bad deal, and her opinion to me was that yah, she should never be near that stuff, as she is unable to moderate, and she is on thin rope already with her history. She was unable to drive for awhile because of the DUI and she helped me with my business instead of working as a nurse. I asked her to stop drinking entirely at about this point in time. I was always okay with a little bit of drinking. But I won't, or can't, so its probably best not to get plastered when it's just us hanging out? She was in agreement, or at least she was when she wasn't drinking. There would be periods of sobriety followed by obnoxious unflattering drunk girl. I had fallen in love at this point. Despite everything I just wrote, I think we are really good together. We are both pretty weird and I think we make a good fit. I really think she thinks the same too. I think she is attractive, very much so, and she is generous with her affection towards me when I need it. We get along, I enjoy being with her pretty much in every case. She is the first girl I have ever really loved. I had relationships before, but nothing I would call really serious. The drinking was stopping and I thought it was near time to propose to her. She saw me ring shopping, and probably expected it to happen on a certain day. That day she was drunk, and I didn't want that to be the way it happened. She probably questioned herself why I didn't and that I think was the impetuous to some more drinking over the next few days. I finally popped the question and we were engaged.
Fast forward a year and some months we get married. We had alcohol at our wedding. She didn't drink any. Neither did I. Our families certainly did. That tramadol that I had mentioned earlier, it was a miracle drug for my chronic back pain. My job is very physical and often times I am the only man to do the job and I just have to suck it up. It made me feel ten years younger. I made sure not to escalate my dose beyond what a doctor would prescribe, albeit at times it was what a doctor would consider on the higher end. It also had this weird side effect that seemed to help with my ADHD. My now wife began taking my tramadol, and we started to share the supply I would get. It was pretty cheap to get over the internet. I also think it is noteworthy she began chewing nicroette gum on the regular at this point. There are empty nicroette gum wrappers everywhere in her desk, the car, purse.
For several years this was the status quo. She went back to working as a nurse. The drinking came back for a period and then left for good. I have found a few empties from her but never drunk. We had a fight when she starting ordering the tramadol on her own. Except now it was it's brother, tapentadol. It was four times the now already increasing price and is stronger but has a shorter half life. I took the pills that she ordered, and flushed them. There was a period here where I caught her with xanax once more. She goes so zombie she left a bunch of it on the bed for me to find.
For about three more years we are taking tramadol. In this time she orders the tapentadol again and takes them without my knowledge at some point. We go on a trip. We have some issues and it ends up taking us a few more days than we had planned to get home. My wife had run out of her drugs and went into one awful withdrawl for me to witness. I mean it was no trainspotting scene but she was really sick and in pain and was not fun for me to watch. I did not monitor how much she took on a daily basis. I don't even think she really knew, she would just take them until she got the effect she was looking for. The price for these drugs had now escalated to a point now where it added up to be serious money.
I had come to a point to realize it would be best to just stop this all entirely. Yes it works great for my back, but it is expensive, illegal, and my wife seems to be having issues controlling it herself. It took me a few months to taper down to zero. It wasn't the easiest thing for me too and I am actually proud of it. I seem to have a restless leg syndrome that just wont ever go away after I stopped, with insomnia. Even as I write this.
She promised she would stop as well. Then didn't, and when I made a fuss she took it underground and off the radar from me. Complained it was all my idea to stop. That's about the time she got her own mailbox so she could have the drugs delivered to her without my knowledge. Periodically I would find a huge fistfull of pills and take them and it would start a fight. She refused to let the mailbox go, said it was needed because mail at our place was unreliable, which has some truth to it so it was hard for me to argue with her on this point.
It is important to bring up another problem that for me seemed to come out of nowhere about this time. I was finding empty nitrous oxide containers everywhere. At some point between her going to or coming home from her nursing job she is huffing whipits. I had never witnessed this kind of behavior from her before.
Finally before a roadtrip that she was looking forward to going to, I told her I was not going to go, unless she was going to come clean with the amount of drugs she was buying. I wanted the details. I wanted bank account information. She absolutely refused and said it was out of line for me to ask for these things. That I just wanted to control her and her money. I think I should add my finances are completely open to her, I really hide nothing, and sometimes I spend money on stupid things. When she finally realized I wasn't budging and apparently she wanted to go bad enough, she gave me the information and was crying. It was thousands of dollars a month for the past year. It went back longer than that but I felt sick looking at it. Overall, tens of thousands of dollars. At least fifty, and likely closer to a hundred over the entire period she was buying drugs on her own. She was crying to me actually being truthful about the situation with herself and me, admitted she needed help and needed to stop. Official rehab is difficult because her nursing license would be involved and compromised.
We go on this trip and we try me giving her her tapentadol drug and slowly taper her off. We get back from this trip and I find another fistful of pills she had the entire time we were on the trip. She often accuses me of gaslighting but she was pretending to withdrawal on this trip and still had her own supply.
Which leads me to this next story that really hurts me. We were at a family gathering. On the way home, I saw her taking some pill out of her purse, in which I inquired about it, probably with a comment with me assuming it was the drug she has promised so often to stop taking. She verbally ripped me a new one. I felt really bad. She chewed me out about how paranoid I always was, always assumed she was taking drugs, never believed her. She wasn't, and isn't exactly wrong. After dozens of times of promising to quit and the lies get more deep to cover it makes a person suspicious. But it's not like I had solid proof of anything. So whatever. But then not just two days later, I find another huge fist full of pills. It's not like I'm exactly looking for them either, but I would be lying if I said I never have. But the vast majority of finds I just stumble into myself. She still says to this day I didn't see what I saw. And that might be actually true, it's hard for me to know. The fact she knew she was taking the pills behind my back and still thought it was right to chew me out like that for being suspicious even if what I saw wasn't what I saw, really, really hurts me.
Last summer we made a good go of it. I was helping her withdraw yet again. And we did it, for about five months. That was the best run of it we have had yet. So this last February, according to her, she starting buying it again and bought more, according to her, this April. I found yet another fistful of pills, while I was digging through the dirty laundry trying to find some pants that had money in it.
So back to the beginning again. I take the pills and she is yelling at me saying I am controlling her. I am trying to take away her autonomy. I am being totally out of line. She has let me access to her bank accounts from the previous episodes but she know I never look. I hate looking. I don't want to be that guy, and she accuses me of being that guy when I try to pin down the truth, or verify. When I point out all the lying she does to me she tells me she only lies to me like that because I am forcing her to do what she doesn't want to do. So if she makes a promise, it never needs to bear any weight.
She has promised not to huff nitrous but has broken that one multiple times just the same, the most recent being just a month or so back. Again I wasn't looking, but jumped in the car and found empties scattered around the seat.
We have yet another roadtrip coming up and I'm not feeling good about it. Mostly because I feel that this last relapse is still very unresolved. Even though we agreed that I would taper her off yet again, I believe she is just telling me that to get me to go on this trip. Its just more lip service. She says I'm trying to punish her.
I don't want to split over this but this has created a giant rift. I still love her through all the hurtful lies she has told me. All the fruitless times I have tried to wean her off of withdrawal symptoms. All the bullshit substance abuse problem history we have. She a nurse practitioner for god damn sake. She has a DEA number to prescribe drugs herself. She should know better. Which is really part of the problem, she really thinks she does know better. I have great anxiety the feds will at any time bust down our doors with an arrest warrant with felony charges. Or I will get another phone call with her crying in jail and she is sorry. With her DUI's the nursing board wouldn't get her another chance. Our credit cards are stuffed, and we find it very difficult to push any money away for a home we are supposedly trying to build. She is now messaging me about how she wishes she never met me, should have left me years ago. She would be talking to me nicely if I would be agreeing to go on this trip. But now that I have told her I don't feel good about it, it is time to leave me.
tl;dr
my wife has addiction problems, i take her pills whenever i find them and force her to withdraw slowly.

Hi friends,
PHOTOS IN THE COMMENTS
I am 5 weeks post op this week and this community was a huge help and was pretty much the only thing I was reading during my recovery - I have a few things to share that hopefully will help a few of you also going through this!
Backstory: 24 year old female, generally healthy however have always had LARGE LARGE tonsils. Would get tonsillitis a lot in high school however didn’t get it “bad enough” for anyone to consider writing me a referral to get them removed. I was prescribed steroids on a few occasions to help the swelling go down as when I would get tonsillitis my tonsils would be so swollen they were touching, almost blocking my airways (love that for me).
Fast forward last year in August I had the worst case of tonsillitis and was unable to get out of bed for a solid 7 days. Regular doctor prescribed antibiotics which I was unresponsive to, tried to go to another doctor to get steroids however it was then that I was finally given a referral to the Ear, nose and throat (ENT) surgeon.
I have always been a snorer and had poor breathing out of my nostrils (and allergies). My snoring got quite bad after that bad case of tonsillitis to the point my partner struggled to sleep beside me.
I went along to my consult and my surgeon (who had been practicing for 30+ years) looked in my mouth and said “Wow, they are something special”…. Not something you want to hear from a person whose seen hundreds let alone thousands of other peoples tonsils lol. He said my quality of life would significantly improve if we removed the tonsils and some of my adenoids.
So I’m in Australia and we have Medicare which means if I waited to go to a public hospital I could get most of the fees covered however it was going to be a 12+ month wait. I decided to go private (a day surgery) and I’m glad I did as I booked in for the surgery within 2 months of my consult. It was about $3700 AUD in total (a small price to pay for how great I feel now)
Many people warned me that this was not going to be a pleasant experience and you need to take the full 2 weeks off work to recover.
I’m annoyed I didn’t take a picture of my tonsils pre surgery but you’ll be able to see from the scars in the upcoming photos how large they were. I had scarring all over my tonsils from the multiple times I had tonsillitis and my right tonsil was double the size of the left one???? dont know how tf that works but anyway.
​
THE SURGERY DAY:

• My surgery was the first one of the day - i think 7.15am/7.30am so I had to stop eating before midnight which was easy because I was sleeping, and no fluids from 5am (again didn't really matter since I had just pretty much woken up and headed straight to the surgery).
• They took my blood pressure, asked a few health questions and asked my weight (so they could give me enough of the drugs to knock me out
• Took me through to the hospital bed room but the funny part was, I actually had to walk myself into the operating theatre, they didn't wheel the bed through. Bit of a strange feeling walking into a room with surgeons and nurses but I was very lucky to have such a great day surgery and everyone was extremely nice and ensured I was as comfortable and relaxed as possible :)
• I'm OK with needles so wasn't too fussed about them putting the cannular in (I used to have a phobia of needles and jabs but I promise as soon as they do it you are like oh wow that wasn't that bad!)
• The last thing I remember pre surgery was them saying "We're gonna give you something to make you relax and the world is going to feel like such a wonderful place!" - I remember literally nothing after she finished that sentence. Whatever they gave me knocked me tf out.

WAKING UP FROM SURGERY:

• Dizzy, confused, very very sleepy - kinda went in and out of sleep for a while.
• They woke me up, gave me more meds through my cannular, I remember feeling super nauseous
• Spoke to the nurse when I woke up and they told me I swallowed a lot of blood during the surgery (which is common) but that was the reason for my nausea mixed with the anaesthetic wearing off.
• Was moved through to the 'post-recovery/pre-pick up from surgery' room, where they gave me an ice block and my surgeon came to check on me. He said all went well and just gave me some info about my pain meds (I'll go into detail about what I was on later)
• Started to feel really sick whilst talking to the surgeon, thought I was going to throw up on him. The second he got up one of the nurses brought over a vomit back and I threw up an impressive amount of blood - I felt amazing after this lol.
• My dad came to pick me up, I was feeling pretty good. My voice was really weird and scratchy

AFTER SURGERY:

• I stayed at my parents house for about a week after surgery (I live with my partner in a share house and thought that probably wasn't the best place to have peace and quiet) and you're going to feel a bit useless, weak and tired, so you definitely want to have someone around who can take care of you for a while.

PAIN MEDS I WAS PRESCRIBED:
Anti-inflammatory meds - twice a day for 14 days
Tapentadol (PALEXIA) - every 4 hours as needed, for 7 days (some people get prescribed codeine or endone but i got this for some reason)
Panadol Osteo (strongest over the counter Panadol - recommended by surgeon) - every 6 hours as needed
Day 1-3 (day 1 being the day of surgery)

• Feeling pretty good, started reading about others' experiences and realised I was doing pretty well and wasn't feeling a lot of pain like other people reported, was eating well and sleeping well
• On day 3, I had acupuncture to help speed up recovery
• Not much happening, chilling in bed/the couch watching a lot of TV, eating vegan ice cream (they say its best to avoid dairy after the surgery as it creates mucus but I try to avoid dairy anyway so this was easy... BEN AND JERRY'S NON DAIRY ICE CREAM IS GREAT.
• I started taking the anti-inflammatory and the panadol for pain management. I didn't feel much pain yet so I didn't start taking the Tapentadol until the night of day 2/morning of day 3 when the pain started slowly creeping in
• Day 3 in the morning I woke up extremely nauseous and threw up due to the Tapentadol, vomiting and nausea is a common side effect of this. I don't cope well with feeling sick so this was enough to make me stop taking the Tapentadol for the time being until I REALLY needed it.
• I was lulled into a false sense of security that maybe I was going to have a super easy recovery and that I wasn't going to feel much pain. I definitely felt quite uncomfortable and talking didn't feel great. I got soft ice packs for my neck WHICH WERE AMAZING. and I got a head band/velcro thing so i could strap the ice packs to my neck and walk around. Honestly, this provided the most pain relief even more than any of my medication prescribed. HIGHLY RECOMMEND!!
• Had to sleep propped up on like 2-3 pillows.

Day 4-7

• Pain kicks in, life sucks.
• Scabs started falling off, leaving open wounds so eating, drinking and living became painful and super uncomfortable.
• I had to use the ice packs SO often (you aren't supposed to use them for more than an hour at a time or something but I would fall asleep with them on as it was the only thing relieving me of the pain.
• Needless to say I ended up calling my friend who was a nurse who got me some anti-nausea tablets so I could actually take my tapentadol without vomitting. I then realised if I ate a big big meal before I took the tapentadol, I wouldn't vomit. So I took the anti-nausea tablets during the night (at this stage I would wake up every 4 hours during the night to take my pain meds otherwise it was BAD).
• It was also at this time that sleeping became really hard. I practically had insomnia, my body did not want to stay asleep. The only comfortable position was laying on my back, which resulted in me sleeping with my mouth wide open. I would wake up with the driest throat and the scabs/wounds in my mouth would crack. This was probably one of the lowest points.
• I BOUGHT A HUMIDIFER and it changed the game. Made sleeping easier and kept my mouth moist.
• Lots of people recommended chewing gum, but it was uncomfortable for me up until about day 9-10 so... if you can chew gum, definetley do it so it keeps the mouth moist - that's how you heal quicker.
• Felt like I was never going to get better and I was going to feel this way for the rest of my life (so dramatic) but if that's how you feel right now I PROMISE IT GETS BETTER. We got this, only a few more days until you will feeel better.

DAY 7

• I slept for about 3/4 hours between 3am - 7am and randomly woke up and was in NO PAIN AT ALL. Hallelujah!!!! I stopped taking ALL OF THE PAIN MEDS as I no longer felt I needed them.
• Felt pretty good other than being tired still. Since I couldn't sleep I spent most nights watching youtube videos - I watched every 'tonsillectomy recovery' vlog there is on youtube lol.
• The day was going well, until I suddenly tasted blood. I went to the sink and spat out what looked like some dark old blood. I didn't panic because the surgeon did say that small bleeds can happen (and super serious bleeding) to about 10% of people who go through a tonsillectomy. Guess who was a part of that 10%?
• At lunch time I started bleeding again, this time a bit more. So I rung the surgery to let them know. They said best to come in and have the surgeon check it out. My partner drove me down, and on the way I was still bleeding. I started to panic (and also hadn't had a decent sleep in days so was over emotional).
• Surgeon prescribed me Tranexamic acid and this is a medicine that controls bleeding. It helps your blood to clot. Twice a day for 5 days, if any bleeding started again after the 5 days, he said i should take it for a further 5 days.
• Had one more small amount of bleeding that evening (you will see the pic of the blood clotting below - yuck sorry!)
• Surgeon advised I should stay on a very soft food diet for the next 5 days to avoid any rough food pulling off any scabs prematurely. My bleed was likely caused by a wound cracking during the night.

Day 8-9

• Started to go outside again for small walks, started to feel more like myself.
• Got tired super easily, so still spending a lot of time resting.
• Started sleeping on my side again which was wayyy more comfortable

Day 10

• Went to a comedy show in the city, was supppperrr tired after that as it was the first proper outing and first time i'd gotten dressed up/put make up on since the surgery. Felt good to be out in society again though
• Voice still sounded a little funny
• Overall a good day

Day 11 - Day 13

• Felt 90% back to normal! Again, just would get tired easily but not surprising as I wasn't back to a regular diet

Day 16

• I felt fully back to normal!!! Yay!!!

TODAY (5 WEEKS POST OP)

• I feel great
• Better sleep quality
• My voice sounds different! My friends and family say I sound less nasally, it's not too too different but enough that they made the distinction.
• MY SNORING STOPPED - fuck yeah!!!
• I can breathe so much better through my nose - I was mouth breathing a lot prior to the surgery which can have bad health effects so i'm very happy about this. I never knew how much the tonsils were blocking my airways!
• I haven't gotten a cold or a sore throat post surgery - all my housemates AND partner got a cold and I somehow didn't get it? Pre surgery I would catch every cold/bug that someone would have in my house.
• Few more good things have happened but I'm having a mental blank - feel free to post any questions below and I'll answer them all.

​
Overall, I had a relatively positive experience. It did SUCK and the bleed was scary, but it was worth it. Would I do it again? Yes - but it did come with a few mentally tough days. You can totally get through it though. It probably doesn't help watching 'TONSILLECTOMY GONE WRONG' or when you see articles about people having horrible experiences, so please don't read them if you can :)
​
I am happy to answechat to anyone going through this because i KNOW HOW SHIT IT IS but you're gonna feel great soon.
​
posting pics in comments below

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Summary

1. Assertio has endured a difficult few years that began with its $1.5bn purchase of opioid treatment Nucynta in 2015 under its former name DepoMed.
2. Nucynta was sold for $375m to a buyer last year as the company swapped opioid treatments for NSAIDs. But much of the damage had already been done.
3. Assertio announced a restructuring in December last year that reduced headcount by >100, to 27. New management is inexperienced but has done a good job settling debts.
4. Its product portfolio is capable of generating >$100m sales per annum. But with no sales staff, perhaps the company is looking to be bought out.
5. In this article I discuss how either a buyout or a turnaround represents a triple-digit upside opportunity for risk-on investors, as the threat of bankruptcy keeps the share price artificially low.
6. Looking for a helping hand in the market? Members of Haggerston BioHealth get exclusive ideas and guidance to navigate any climate.

Investment Thesis
Assertio Holdings (ASRT) stock is currently trading at a price of $1 and flirting with Nasdaq delisting laws, but was the subject of a $33 per share buyout offer as recently as 2015. The company is unrecognisable from the marketer and seller of opioid-based drugs it was then, and a lot of deadwood has been removed by the current inexperienced yet dynamic management team. Its product portfolio is now virtually opioid-free, focused on NSAIDs, and delivering sales of $93.5m in full-year 2020. Meanwhile, management has settled nearly all of the company's historical debts, disposed of all but 27 staff, and is focused on settling all outstanding litigation.
The signs may point to management now putting up the "for sale" sign, and completing a sale to a better resourced, more experienced competitor, but as I will argue in this post, there is also an argument that by switching to a digital-only sales model it could complete an unlikely turnaround, grow the share price and raise money for further acquisitions.
The other alternative - which cannot be ignored - is bankruptcy. In the rest of this post I will discuss Assertio's history as a company - including under its former name of DepoMed - cover recent developments in detail, and explain why bankruptcy, sale or success are the three scenarios investors ought to consider when weighing up the company as a potential buy opportunity.
In my view, the "sale" and "success" scenarios are more likely, and following them through to their logical conclusions, offer >100% upside in relation to Assertio's current trading price. In this game of commercialised drug portfolio poker, I believe Assertio is holding the aces, thanks to a mixture of historical accident, market appreciation, and chutzpah.
Company Overview - Transformation from Opioids To Slimmed Down NSAID Operation
Formerly known as DepoMed, in 2015 the company spent $1.05bn acquiring the rights to the opioid treatment Nucynta - an approved oral form of the opioid analgesic Tapentadol - from Janssen Pharmaceuticals, a subsidiary of Johnson & Johnson (JNJ).
Nucynta had made sales of $166m in the 12 months to September 2014, and with patent protection until 2022/23 at the earliest, was viewed by management as a flagship asset, complementary to its existing portfolio of commercialised treatments targeting pain and CNS disorders, and potentially capable of making blockbuster (>$1bn per annum) sales. DepoMed were so bullish on future sales that management rejected a $33 per share acquisition offer from Horizon Therapeutics (HZNP).
Instead, DepoMed became embroiled in the backlash against the sale and marketing of opioid-based drugs, named in an investigation conducted by Sen. Claire McCaskil as one of a number of companies - including Mylan, Purdue, and Janssen - over payments made to advocacy groups who supported and promoted the use of opioid treatments, and the subject of widespread litigation which I will discuss later.
In 2017, with Nucynta averaging ~$250m of annual sales in the years since acquisition, and debt climbing to unsustainable levels, DepoMed sold its license to the drug to Collegium Pharmaceutical (COLL) in exchange for a $10m upfront payment, a minimum of $135m in royalties per annum for a period of four years, and a double-digit percentage royalty on net sales exceeding $235m, plus ongoing double-digit royalties after the expiration of the initial 4-year agreement.
The deal suited both parties, with Collegium believing it could revive sales of a depressed asset, and DepoMed determined to put its opioid experience behind it, which prompted the name change to Assertio in August 2018.
With its mounting debt concerns however, Assertio agreed to the sale of all of its remaining rights in Nucynta for an upfront cash sum of $375m in February this year, and also sold its anticonvulsant medication Gralise to Alvogen in a $130m deal, allowing it to pay off the remaining $162.5m of its $575m of senior secured notes issued in 2015, and repurchase $188m of the aggregate principal amount of its outstanding 2021 Notes and 2024 Notes, before issuing a tender offer to repurchase the remaining $77m outstanding.
Having disposed of all but ~$80m of its long term debt, at the expense of the majority of its revenue generating assets, Assertio agreed to merge with Zyla Life Sciences (OTCQX:ZCOR) in May last year, with each outstanding share of Zyla common stock converted into 2.5 shares of Assertio Holdings.
That gave the company control of Zyla's INDOCIN Products - suppository and oral forms of the nonsteroidal anti-inflammatory drug ("NSAID") Indomethacin, and SPRIX - a nasal spray formulation of Ketorolac Tromethamine indicated for pain relief, plus 2 non-promoted products, OXAYDO - an oral tablet form of the opioid Oxycodone - and SOLUMATRIX - consisting of ZORVOLEX (diclofenac) and NSAID VIVLODEX - which appear to be being discontinued, since a statement in Assertio's 2020 10K submission refers to the cessation of a manufacturing agreement with iCeutica for SOLUMATRIX products.
After the merger, Zyla CEO Todd Smith became CEO and President of Assertio, replacing Arthur Higgins, who became non-executive Chairman. Zyla's Chief Commercial Officer Mark Strobeck became Assertio's new CCO. The new leadership team only lasted until December, however, when Assertio announced a restructuring intended to reduce the company's cost base by $45m, on top of the $40m of synergies created by the Zyla merger.
Both Smith and Strobeck resigned, with Dan Peisert - Assertio’s Chief Financial Officer - promoted to CEO and President. To complete a roller-coaster year, in December Assertio made 107 staff redundant - including all of its field sales force - leaving just 27 staff remaining.
As such, Assertio is barely recognisable from the company it was 12 months ago, let alone subsequent to its name change in 2018. The company's shares now trade at $1, and have been granted a 180-day extension to comply with Nasdaq listing regulations, which requires Assertio stock to exceed $1.00 per share for a minimum of 10 consecutive business days on or prior to June 28, 2021.
On its Q420 earnings call CEO Peisert outlined 6 strategic priorities for Assertio in 2021:
The priorities for 2021 are as follows; build a strong and committed team with a culture of teamwork, inclusion and results, delivering on our 45 million of restructuring synergies, ensuring the company generates strong operating cash flow, ensuring our debt never becomes a constraint in running the business, mitigate our legacy legal uncertainties and develop a sustainable business model that reflects a changing environment.
After all of the upheaval, Assertio shareholders may be looking forward with optimism to what the new management team can achieve in 2021 and beyond.
The company's products (including Zyla) generated sales of $126m in FY19, and $106m last year. Operating expenses in FY20 totalled $188m, resulting in a net loss of $82m, but with its cost base and debt now drastically reduced, and a shift to a new digital-only sales model, the overall picture ought to improve, even if revenues suffer slightly.
Portfolio & Market Overview
Management will feel that the decision to discard their portfolio of opioid treatments puts them in the right market - one which is progressive, growing and supported by the regulatory authorities, rather than one which was damaging to their reputation and increasingly to their chances of becoming profitable.
Cambia - an oral solution of Diclofenac Potassium used to treat migraine attacks - and Zipsor - liquid filled capsules of diclofenac potassium for relief of mild-to-moderate pain in adults - are the only DepoMed legacy assets still marketed and sold by Assertio, making sales of $28m and $13m respectively in FY20.
Indocin is indicated for moderate to severe Rheumatoid Arthritis, Ankylosing Spondylitis, osteoarthritis, gouty arthritis and acute painful shoulder, achieving $32m of revenues in FY20, and Sprix made sales of $11m last year.
During the pandemic Assertio had to get used to operating with a severely restricted sales force, as CEO Peisert discussed on the company's Q420 earnings call:
We had 80 reps in the field or 80 territories that we had. At best we were seeing 40%, 50% of our calls made in person. So we had a very strong virtual promotion last year just because of what COVID did and COVID was also in some ways worse than what you'd expect normally because patients weren't going to go visit their physicians.
Management was not prepared to comment on their expectations for how far sales volumes might decline in FY21 with no field sales force to speak of, and says that guidance will be withheld until Q121 earnings are released, but CEO Peisert did sound an upbeat note about the prospect of reverting to digital marketing:
Building upon our experience in the past year we've begun our own first steps in this direction by continuing with telesales, telesampling and email campaigns and we've seen that Assertio products are excellent candidates to be promoted in this manner.
It's a reasonable defence of the decision to downsize operations, although it is one thing to have reduced face-to-face client contact in an environment where rivals' operations are also restricted, but an entirely different challenge to attempt to operate with no face-to-face contact in a BAU environment.
Assertio's products are quite generic in nature. Indocin, for example, is marketed under at least 12 brand names (according to Wikipedia), and targets a fiercely competitive market in which almost all major pharmaceuticals are active, and all are developing new and improved treatments.
In fairness, the Rheumatoid Arthritis market alone is valued at ~$25bn today and expected to grow to $36bn by 2026, and Assertio may think that their established sales funnels will survive so long as physicians are satisfied with the product and the price point.
But whether Assertio will be able to compete on price whilst operating a skeleton service is also questionable - the company may be planning hikes to compensate for falling sales. Will physicians be satisfied dealing with a company that lacks market experience and know-how?
Departure of Chairman and Independent Director a mixed blessing?
In this respect, the company's Board of Directors may be able to provide a helping hand, although at this point the plot thickens still further.
Arthur Higgins - a Pharmaceutical industry veteran who was Chairman of the Board of Management of Bayer HealthCare AG between 2006 and 2010, and has a net worth of $93m according to this source, and Timothy Walbert - Chairman, President and CEO of $20bn market cap commercial biotech Horizon Therapeutics (HZNP) (my October '20 note here) are listed as non-executive Chairman and Lead Independent Director respectively in an October '20 Assertio Corporate Presentation which now appears to be long out of date, and it is unclear if either is still in their position.
There is no mention of either on the company website and no mention in the 2020 10K submission, however, which suggests they may no longer be involved in the business - although Walbert's LinkedIn profile still refers to his role as ongoing. Whilst this might be a plus in some ways as both may have been well-remunerated, and their absence represents another fresh start for Assertio, the company may have benefited from their influence in terms of marketing and client/physician relationships.
Assertio's listed board members are Heather Mason, a former executive vice president (EVP) of Abbott Nutrition (ABT), James Tyree, former President of Abbott Biotech Ventures, a subsidiary of Abbott Laboratories, William T. McKee, former CFO at Barr Pharmaceuticals - acquired by Teva Pharmaceuticals - and Chairman Peter D. Staple, who according to his Assertio Bio is CEO and director of Corium International, Inc., a publicly held biopharmaceutical company, although Corium seems to have been acquired by Gurnet Point Capital in 2018.
Litigation Still Outstanding
If Assertio's sales and marketing concerns were not enough, the company is still facing a significant number of lawsuits mainly relating to the fallout from the opioid crisis.
In the "Legal Matters" section of its 10-K released last week, Assertio lists a number of claims against the company. My layman's understanding and brief summary of the cases is as follows.
The first involves Glumetza, a diabetes drug developed by Assertio. There are several cases are being brought by former buyers of the drug, including CVS Pharmacy (CVS), Rite Aid, Walgreens (WBA), and health insurer Humana (HUM) alleging that Assertio and Bausch Health paid Lupin Pharmaceuticals - who had developed a generic version of Glumetza - to delay its entry to the market, and in exchange, promised not to compete with an authorised generic for the first twelve months that Lupin’s generic was on the market. A trial may initiate in October 2021.
Two former members of Assertio Senior Management are being sued by shareholders in relation to misleading disclosures about the company and its business, compliance, and operational policies and practices concerning the sales and marketing of its opioid products. After initially dismissing the claims, the court has granted the parties’ joint motion to stay the appeal pending settlement discussions. Assertio comments that it believes the case is without merit, but cannot predict the outcome of the matter. There appears to be 4 more cases being brought which are also stayed pending the outcome of the appeal.
Assertio has been subpoenaed on numerous occasions by regulatory and government authorities in relation to its marketing of Lazanda, NUCYNTA, and Gralise (a non-opioid) and continues to cooperate and respond to enquiries.
Numerous federal and/or state statutory claims, as well as claims arising under state common law have been filed by a wide variety of plaintiffs, in relation to alleged deceptive marketing practices - Assertio intends to defend itself vigorously.
Assertio entered into a Confidential Settlement Agreement and Mutual Release with Navigators Specialty Insurance Company and the coverage action was dismissed without prejudice.
Finally, Patrin Pharma filed an abbreviated New Drug Application ("ANDA") seeking to market a generic version of CAMBIA prior to the expiration of patents. Assertio launched a suit against Patrin jointly with its licensor Applied Pharma Research ("APR"). Earlier this month, the Company entered into a confidential settlement agreement with Patrin.
I am not a legal expert but the above sounds like another difficult set of circumstances for the new management team to deal with, although to what extent they or Assertio have liability now that much of the previous management has departed is unclear. Legal matters are expensive to deal with and will likely place an additional strain on Assertio's already stretched financial resources.
The patent issue is also troubling. Cambia is patent protected until 2026, and Sprix and Zipsor until 2029, but that does not necessarily mean that other firms will not submit ANDA's as Patrin did, creating yet more legal expenses and a slump in sales if the ANDA's are successful.
Will Assertio Stay The Course?
Since its acquisition of Nucynta back in 2015, arguably not much has gone right for first DepoMed, and now Assertio. The company entered the opioid market at precisely the wrong time and quickly became both indebted and subject to federal enquiries and litigation in relation to its marketing practices.
The company secured a reasonable exit from Nucynta with its structured deal to sell the license to Collegium, but was ultimately forced to settle for a $375m cash payment rather than a share of ongoing royalties.
The merger with Zyla brought a portfolio making sales in the triple-digit millions to the table, but the apparent departures of most of the key players in that deal - from Zyla management, to Assertio's Chairman and possibly its Lead Independent Director also, has been followed by the laying off of its entire sales force, leaving only 27 staff at the company.
The current management team has limited experience on the marketing side, but will attempt to press ahead with a digital-only strategy, hoping that it will not severely impact sales. Having apparently done a good job settling Assertio's debts, there remains outstanding litigation to be addressed which could become a substantial drain on resources, and the company reported just $21m of cash as of Q420.
Finally, Assertio is struggling to maintain compliance with Nasdaq listing laws and has until June to exceed a minimum closing price of $1 for 10 days consecutively.
Investors who are unwilling to embrace a high level of risk (will Assertio even be a listed entity in 12 months' time?) would probably do well to steer well clear of Assertio, but for those who favour a risk-on, high-risk, high-reward investment, it's possible to argue the bull case for Assertio.
First of all the company has drastically reduced its overheads, taking the ruthless - or necessary, depending on how you look at it - decision to eliminate its sales force and retain just 27 employees. The December restructuring is expected to save $15m per annum whilst management says cost synergies of $40m have been achieved since the Zyla merger. Finally, Chief Financial Officer Paul Schwichtenberg commented on the earnings call:
because of the recent restructuring we expect in 2021 to achieve additional SG&A savings off of the annualized second half 2020 operating expense run rate including opioid legal cost. For clarity our pre-restructuring operating expense run rate including our opioid legal costs for the second half of 2020 is 43.7 million which translates into an annual operating expense run rate of approximately $87.4 million. In 2021 we expect to achieve $40 million of savings off of this run rate and ultimately $45 million in annual savings beginning in 2022.
Assertio's total costs and expenses in FY20 were $188m, which includes loss on impairment of goodwill and intangible asset charges of $17m and restructuring charges of $17.8m, plus $24.8m amortisation. If we ignore these and focus on COGS, SG&A and R&D - total $128.5m - and subtract $40m, to get $88.5m, and if we remain optimistic on FY21 sales and forecast a 15% annual drop-off - to ~$79.5m, we can see that Assertio would not be too far away from breaking even in FY21 - and litigation costs have been factored into the equation.
Assertio's lack of funds would remain an issue, however - the company still has ~$80m of debt to service, and $132m of near-term liabilities versus $94m of near-term assets (as shown below), but 2 recent share offerings offer some encouragement, as well as, unfortunately, further dilution.
On February 9th, Assertio completed a registered direct offering with certain institutional investors and accredited investors, selling 22,600,000 shares of common stock at a purchase price of $0.62 per share, raising $14m, and on February 12th, the company sold 35,000,000 shares of common stock at a purchase price of $0.98 per share, raising ~$34m.
Whether the uplift in price between the first and second offering is significant - suggesting demand for the stock was high - is open to question, but the fundraising is another example of a capable management team, in my view, that have displayed proficiency both in settling debts and raising funds. The downside is that Assertio's share count has risen to >170m.
Management has expressed an interest in making strategic additions to the existing product portfolio, stating in its offering prospectus that it may use funds to "acquire or invest in complementary businesses, products and technologies", whilst also preaching conservatism in its approach to new opportunities.
The Acquisition Option - Will Management Sell The Business?
In reality, I think it would be very difficult for Assertio to pull off any acquisitions in its current straitened condition, but management may be teasing the idea, perhaps in order to make itself an acquisition target.
That would certainly be a logical option for the current team to pursue, because although a new Chief Accounting Officer, Chief Financial Officer, Head of Investor Relations and Legal counsel have been appointed, there remains no Chief Marketing Officer. That begs the question as to how serious management is about attempting to make the current portfolio work long-term.
Having taken control of the business, overseen the departure of staff, and senior management and directors, and settled the majority of its debt, Assertio management may be about to place the "for sale" on the product portfolio and wait for prospective buyers to make them an offer.
The company's current market cap is $168m, but how much would a prospective buyer be prepared to pay? My guess is substantially more than that, when we think about a price to sales ratio of <1.5x based on Fy20 revenues, plus the fact that there are companies in the market launching ANDA's to market generic versions of e.g. Cambia. Maybe a quicker and easier path to profitability for these companies would be to complete a buyout of Assertio and gain access to the desired product, plus several more complementary assets.
3 Possible Scenarios - Bankruptcy, Sale or Success
Based on my research I think there are 3 possible endings - or new beginnings - to the Assertio story.
Let's start with the worst-case scenario. Assertio lacks the sales and marketing know-how to continue to sell its portfolio of assets and rapidly loses market share to rival companies. Its existing relationships with prescribing physicians and positions on formulary lists dissipate quickly and management are unable to make sufficient cost savings to make the business work. Assertio fails to regain compliance with the Nasdaq and eventually files for bankruptcy.
This would clearly be bad news for retail investors, who would be unlikely to recoup an investment of $1 per share, and may have to settle for less than half that figure as an asset fire sale takes place.
Now let's consider a scenario where management goes all out to try to make a success of the business. Existing sales channels are not impacted, and the product portfolio even increases sales year-on-year as pandemic pressures ease and the switch to a digital marketing approach pays off, making selling a more seamless and streamlined process. The company makes it through FY21 and breaks even, whilst the share price gains on positive Q1 and Q2 earnings, allowing management to raise further funds and target new product acquisitions. An experienced Director of Marketing is appointed to implement a long-term digital platform-based sales strategy.
Clearly, this would be very good news for investors. The market for NSAIDs is forecast to grow in size to $24.35bn by 2027, at a CAGR of 5.8%, so it is also a credible thesis, in my view. Assets such as Indocin, Sprix, Cambia et al have never failed to sell, they have simply been owned by failing businesses that have found themselves in a situation where their best option has been to pass them on. Even Zyla, under its former name Egalet, had been filing for bankruptcy owing to the failure of its tamper-resistant opioid products at the same time it was acquiring Indocin from Iroko Pharmaceuticals in 2018.
The final scenario is one in which Assertio continues to play poker whilst it waits for an acquisition bid. Management acts as though it expects to be there for the long term and continues to manage the company's debt and its litigation concerns, but also lets it be known that it will sell at e.g. $3 per share, valuing its assets at just over $500m. As with Nucynta, a buyer presents itself before Assertio has eroded its existing sales channels and a deal is completed before the end of the year.
In this scenario, again a retail investor would theoretically win, having shown faith at a difficult time for the company. The current saga would end with management being rewarded for its good stewardship during very challenging times, and a better resourced, more experienced company would take over a triple-digit-million revenue generating portfolio of assets, using its established sales and marketing channels to stimulate long-term revenue growth.
Conclusion - Management's Momentum Can Deliver The Desired Upside
3 scenarios, 2 of which are optimistic and 1 pessimistic. Arguably, the odds are stacked in favour of a positive outcome for Assertio and its shareholders, with potentially, 300% upside a possibility. Due to the state of its finances, it ought to be clear after Q1 earnings are published and FY21 guidance released which is the most likely outcome of the 3 I have highlighted above.
If sales are in freefall as of Q121, that is clearly a problem that management may find it all but impossible to reverse, and prospective acquirers may be able to name their price for the company - although I still believe they would be prepared to pay a significant premium to $1 rather than waiting for Assertio to go bankrupt and participate in an asset firesale. Paying an extra $50-80m to gain access to the portfolio 12 months earlier by completing a buyout at ~$250m would represent good business, in my view, and earn a nice premium for investors of ~50%.
Personally, I think the strength of the current portfolio tilts the balance in favour of a positive outcome. I agree with management that its NSAID portfolio could almost sell itself. The proof for this is that their sales performance across 3 different companies has always been consistent. It is doubtful that Assertio's focus in the final quarter of 2020 had been 100% on product sales given all the upheaval at the firm, and yet its products made a healthy $29.8 of sales under pandemic conditions, not BAU.
As such healthy Q1 results would rapidly push up Assertio's share price and force the hand of any would-be acquirer, in my view, who I could see paying up to $2.5 per share for a quick deal.
And if management does complete an unlikely turnaround, raise further funds - possibly using convertible debt as opposed to share issuance - to make further acquisitions, and establish a healthy, non-controversial product portfolio, that is when shareholders stand to gain the most. Stocks as cheap as Assertio's are capable of generating rapid price momentum and a good strategic acquisition of a successful pain relief product can transform a company's fortunes - remember Horizon's offer to buyout DepoMed at $33 per share?
As such - despite how things may look at Assertio now - stripped of its best-selling assets, its staff, and management, and desperately trying to stay afloat, the company is not quite the basket case the market may think, and there is a clear opportunity for risk-on investors to generate triple-digit upside in a short space of time.

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Pain killers are not always harmful when you are choosing the right medicine and using it as per the instructions given by your doctor. When you go for Generic buy Tapentadol (Nucynta), remember that generic medicine also works in the same way as the generic medicine works, and hence you need to be careful while taking this medicine also as it may also get addicted when taken if not necessary.
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When you have gathered so much information about medicine, it is now time to look for the right place to buy this medicine and a safe place to Buy Tapentadol safepillsmart.com. Nowadays, placing the order online is safer than buying it from any other local drug store. You can buy the same medicine at an unbelievable price and you will be saving some bucks as well. So, order your medicine now.