Opioid Litigation

Opioid Litigation

Municipal and County governments, like Suffolk County, New York are currently pursuing litigation against leading opioid manufacturers for the County’s medical, public health, and law enforcement costs related to opioid abuse. The lawsuits allege that the opioid addiction stems from the manufacturers’ over promotion and sales of prescription opioid medications such as OxyContin and Percocet.

Dr. Andrew Kolodny, the co-founder of Physicians for the Responsible Opioid Prescribing group, provided the following analysis of the Suffolk County case to a New York NPR affiliate, explaining how the broader Suffolk County lawsuit gets to the heart of why doctors were over prescribing opioids.

“We were responding to marketing – really a brilliant marketing campaign – and in some cases marketing disguised as education – that led us to believe that the risks of addiction had been overblown, led us to believe that we had been allowing patients to suffer needlessly, that we could be more compassionate if we prescribed opioids more liberally; and that campaign was filled with misinformation,” he said in the article.

New York Counties File Opioid Lawsuits for Aggressive Marketing

Several county governments in New York are currently considering filing their own opioid lawsuits that make similar allegations to the Suffolk County litigation, including:

• Defendants knew that, except in exceptional circumstances, opioids are too addictive and debilitating for long-term use for chronic non-cancer pain.
• Defendants knew that with prolonged use, the effectiveness of opioids wanes, requiring increases in doses to achieve pain relief, markedly increasing the risk of significant side effects and addiction.
• Defendants knew that controlled studies of the safety and efficacy of opioids were limited to short-term use in managed settings, where the risk of addiction was significantly minimized.
• Defendants misrepresented the dangers of long-term opioid use to medical professionals, pharmacists, and patients, dramatically expanding opioid use.
• Defendants created a false perception of the safety and efficacy of opioids among medical professionals to encourage use of the medications for a wider range of problems through a deceptive marketing campaign, beginning in the late 1990s and continuing to the present. This marketing campaign failed to achieve any material health care benefits.
• As a direct consequence of the Defendants’ wrongful conduct, plaintiffs have spent millions of dollars in year in efforts to combat the public nuisance created by this deceptive marketing campaign.

The Opioid Epidemic

The toll opioid addiction has taken on American society as a whole has been commonly referred to as the “opioid epidemic.” According to the National Institute on Drug Abuse (NIH), it is estimated that between 26.4 million and 36 million people abuse opioids worldwide. An estimated 2.1 million people in the U.S. suffered from substance use disorders related to prescription opioid pain relievers in 2012, and an estimated 467,000 were addicted to heroin.

The opioid epidemic has been called the worst drug crisis in American history, and the associated death rates are comparable to those of AIDS in the 1990s, according to a Frontline report. The epidemic has hit nearly everyone, regardless of race. Every racial demographic has seen more overdoses since 1999, with heroin spiking especially after 2010. Whites and Native Americans have experienced the largest rise in death rates, particularly when it comes to opioid-related fatalities. By 2014, whites and Native Americans were dying at double or triple the rates of African-Americans and Latinos.

The total number of opioid pain relievers prescribed in the United States has skyrocketed in the past 25 years. The number of prescriptions for opioids have risen from around 76 million in 1991 to nearly 207 million in 2013. The United States is the biggest global consumer, accounting for almost 100 percent of the world total for hydrocodone and 81 percent for oxycodone. An estimated 165,000 Americans died from opioid overdoses between 1999 and 2014.

The Real Costs of Opioid Addiction

Aside from the pain caused to individuals and families affected on a personal level by this addiction crisis, communities across the United States have shouldered real costs in trying to combat the opioid epidemic. The annual estimated economic burden of prescription opioid abuse in the United States totals a startling $78.4 billion dollars. This breaks down to an average aggregate distribution as follows:

• Lost Productivity: $42 billion (53.3%)
• Health Insurance: $26.1 billion (33.3%)
• Criminal Justice: $7.6 billion (9.7%)
• Substance Abuse Treatment: $2.8 billion (3.6%)1

1 Sources: The National Center for Injury Prevention and Control, The Centers for Disease Control and Prevention

Opioid Addiction and Overdose

Opioids like OxyContin and Vicodin are typically prescribed for the treatment of moderate to severe pain.  They act by attaching to specific proteins called opioid receptors, which are found on nerve cells in the brain, spinal cord, gastrointestinal tract, and other organs in the body.  When these drugs attach to their receptors, they reduce the perception of pain and can produce a sense of well being and pleasure; people who abuse opioids often seek to intensify their experience by taking the drug in ways other than those prescribed.

Anyone who takes prescription opioids can become addicted to them, and as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. In 2014, nearly two million Americans either abused or were dependent on prescription opioid pain relievers, according to the Centers for Disease Control and Prevention (CDC).

Types of Prescription Opioids

Taking too many prescription opioids can stop a person’s breathing—leading to death. Opioids include both brand name and generic versions of the following:

• OxyContin
• MS Contin
• Dilaudid
• Dilaudid-HP
• Butrans
• Hyslingla ER
• Targiniq ER
• Actiq
• Fentora
• Duragesic
• Nucynta
• Nucynta ER
• Opana
• Opana ER
• Percodan
• Percocet

Every day, over 1,000 people receive treatment in emergency departments for the misuse of prescription opioids, and U.S. law enforcement officers are shouldering the heavy burden of responding to an endless string of narcotics-related calls while attempting to protect themselves from exposure to lethal substances including the potent opioid fentanyl, which is up to 50 times more potent than heroin.

Other Opioid Litigation

Other counties and municipal governments around the U.S. are currently pursuing opioid litigation against pharmaceutical companies, including:

• In December 2015, Mississippi made claims against Purdue Phama, Teva Pharmaceutical Industries, Cephalon, Johnson & Johnson, Janssen Pharmaceticals, Ortho-McNeil-Janssen Pharmaceuticals, Endo Health Solutions and Allergan, formerly Actavis, alleging that the pharmaceutical companies have violated the state’s Medicaid Fraud Control Act by fraudulently marketing and selling “highly-addictive, opiate-derived” painkillers for unsafe and ineffective purposes.
• In May 2016, a Pike-County, Kentucky judge granted a motion by a news outlet to unseal court records from a lawsuit by the state accusing Purdue Pharma of fraud, conspiracy, and negligence in the development and marketing of OxyContin. Purdue settled the lawsuit in December 2015 for $24 million, but did not admit wrongdoing.
• West Virginia’s attorney general is currently suing one of the country’s largest drug distributors, McKesson, for allegedly failing to curb suspicious orders for controlled substances after an investigation conducted by the state’s Attorney General uncovered that the company distributed about 99.5 million doses of hydrocodone and oxycodone to West Virginia between 2007 and 2012.

Taking Action Now

Communities have the ability to make a difference now in their fight against the opioid epidemic by taking the following preventative actions.

Be Aware: Recognize the opioid manufacturers’ marketing tactics for what they are.

Be Proactive: Account for community costs associated with the following:

1. Opioids
2. Addiction treatment involving opioids
3. Social costs related to opioids and addiction
4. Programming and training costs related to opioids and addiction

Be Prepared: Know your legal rights – both individually and collectively.

Filing a Community Opioid Lawsuit

Municipalities, county governments and other community organizations may be able to hold the pharmaceutical companies responsible for the opioid epidemic responsible and begin the healing process.

Communities, by filing lawsuits, are seeking to hold drug companies responsible for the following costs:

• Health care costs
• Criminal justice and victimization costs
• Social costs
• Lost productivity costs
• and more.