The Opioid Crisis: Holding Pharmaceutical Companies Responsible

Tiny Vinton, Ohio, where massive amounts of opioids were shipped.

Much has been said about who is to blame for the opioid crisis impacting America, especially portions of rural America.  Some would blame the users, others would blame physicians, others blame economic distress, but, in my view, the real villains are the pharmaceutical companies, who like gun manufacturers, care nothing about the consequences of their product.  Rather their sole focus is seller ever larger quantities and to make more and more money.  Part of this effort includes wining and dining physicians and other prescribers and pushing them to prescribe more and more product.  Part of it is advertising campaigns to encourage patients to ask their doctors for prescriptions.  Yet another part is turning a blind eye to what even in passing would be insane quantities of opioids being shipped to small communities. Now, as the Washington Post reports, localities and states are seeking to hold pharmaceutical companies for the damage their products and their negligence have done.  Here are article highlights:

Vinton Ohio — The opioid epidemic has affected nearly every aspect of life in Vinton County. Teachers buy shoes for students whose addicted parents send them to school in footwear held together with tape. Overdose deaths have surged. Foster care is overwhelmed. The jail is bursting at the seams.

The expenses related to caring for the children of drug abusers and locking up drug offenders here eat up about 25 percent of the Ohio county’s $4 million annual budget, a hole that it can’t plug. Now, Vinton officials think someone should help foot the bill: Big Pharma.

“It almost feels like Vinton County was preyed upon,” said Lily Niple, who got addicted to prescription opioids here but managed to push through, having been clean for more than two years. “It’s like a huge exploitation of the people here. And it was negligent. Just complete disregard for the future.”

[T]he biggest fight against the opioid epidemic is being waged in a federal courthouse in Cleveland, where hundreds of lawsuits brought by cities, counties, Native American tribes and unions have been brought together into one case with a scope that rivals anything seen in the U.S. legal system. Vinton County and hundreds of other municipalities across the nation are suing companies that manufactured and distributed powerful painkillers and others up and down the supply chain, arguing that they knowingly peddled massive amounts of a highly addictive product that set in motion a public health crisis. The plaintiffs argue that the vast network of opioid businesses should pay for the damage the drugs wrought.

“This is probably the most complex piece of litigation in the history of our country,” said Paul J. Hanly Jr., one of the lead plaintiffs lawyers.

The consolidated case is being compared to the one that led to hundreds of millions of dollars in settlements against tobacco companies and restricted the sale and marketing of cigarettes. Some of the same tobacco lawyers are now working on the opioids trial.

Plaintiffs are making different, but similar, claims and suing various companies in the drug pipeline. Some allege the drug companies created a public nuisance with their products. Others argue that deceptive marketing led to an epidemic. Some say state consumer protection laws were violated. Some of the lawyers allege that the distribution system, which includes wholesalers and distributors of powerful narcotics, amounted to a criminal enterprise. A small group is suing pharmacy benefit managers. Some are suing pharmacies. One lawyer is suing on behalf of children born to mothers who were addicted to opioids.

The Justice Department filed a motion this past week requesting that it be allowed to participate in settlement discussions as a friend of the court. Attorney General Jeff Sessions said the department would seek repayment for the cost of the drug crisis because the federal government has borne substantial expenses. The sheer number of defendants in the case — more than a dozen — also is staggering and unprecedented. And they could start pointing fingers at one another. They include the manufacturers Purdue Pharma and Janssen Pharmaceuticals, the distributors AmerisourceBergen, McKesson and Cardinal Health and pharmacy benefit managers such as Express Scripts. The litigation comes as people at all levels of government have identified opioid abuse as a major public health — and societal — woe, one that thus far has defied solution. And in many ways, lawyers and legal experts say, the opioid lawsuit is different and far larger in scope than efforts such as the action against Big Tobacco.

The opioid epidemic kills hundreds of people each day, akin to the 1918 flu pandemic. The judge overseeing the case, Dan Aaron Polster of the Northern District of Ohio, said during a January hearing that this scourge was man-made and that lawyers need to reach a resolution quickly, because approximately 150 people are dying each day.

 The White House Council of Economic Advisers estimates that the economic cost of the opioid crisis was $504 billion just in 2015, or 2.8 percent of that year’s gross domestic product. Altarum, a nonprofit organization that studies health care, estimates the opioid crisis cost the country more than $1 trillion from 2001 to 2017. Mark Chalos, a lawyer who represents communities in Tennessee and some unions, said the toll is tremendous, “a preventable catastrophe . . . made entirely by an industry that operates in plain view.” [Judge] Polster is taking a unique tack — he is not interested in litigation for the sake of litigation. Instead, he wants to help solve the crisis and do something to “dramatically reduce the quantity” of opioids being disseminated, manufactured and distributed, he said in a January hearing. He also wants to ensure the drugs are being used properly. It is not the first time that some of the companies have been pursued in the courts. In 2003, Hanly sued Purdue Pharma, which makes the powerful synthetic opioid painkiller OxyContin. The company paid out $600 million, and three executives pleaded guilty to criminal charges that they misled doctors, regulators and patients. But the epidemic raged on. The judge also put a protective order on what lawyers say is likely the linchpin of the case: information from a database kept by the Drug Enforcement Administration that monitors the flow of prescription painkillers from manufacturer to distribution point.

After initially resisting, the DEA said it would disclose some of the data, including identifying the manufacturers and distributors that sold 95 percent of the opioids in each state from 2006 to 2014. Lawyers say the full set of data could provide a road map for the crisis, perhaps showing a correlation between where the drugs flooded and where people died. . . . . but some information that has been released and analyzed is staggering: In two instances, millions of pills were shipped to pharmacies in tiny West Virginia towns.

In Vinton County, where 13,000 people live among the rolling hills and creeks, an average of 113.5 doses of opioids were dispensed per resident here in 2012, according to state data.

Despite what Republicans will bloviate, industries cannot be trusted to regulate themselves.  They have only one true god:  money.  Who gets hurt or dies as a consequence all too often is nowhere in the equation.  The quantities of opioids shipped to tiny Vinton, Ohio,  make it clear that manufacturers and suppliers knew something was seriously wrong, but did nothing.  All they cared about was profit.   The GOP effort to create a new Gilded Age is witnessing the same kind of abuses that ultimately were reined in during the first decades of the 20th Century.  It seems Republicans learned nothing.