Making opioid companies pay
Orange County will join over 200 governments nationwide, including 15 in North Carolina, suing drug makers and distributors over the opioid crisis.
Drug overdose is now the leading cause of death for Americans under age 50.
Nationwide, more than 64,000 people died from opioid poisoning in 2016. In North Carolina, there were 1,518 deaths – 90 percent more than in 1999. Half died from commonly prescribed medications, state reports show.
The result also has been an increased public cost to provide medical care for addicts and opioid-addicted babies, welfare and protective services for children with opioid-addicted parents, and front-line law enforcement and public safety services, attorney Amy Quezon told the Orange County Board of Commissioners.
Opioid manufacturers and distributors bear some responsibility for those costs, which have hit Appalachian and rural, Southern communities especially hard, said Quezon, with McHugh Fuller Law Group, part of a consortium of national law firms behind the lawsuits.
The Orange County Board of Commissioners also think the companies should bear some responsibility, Chairman Mark Dorosin said after last week’s vote.
“I think the commissioners were concerned about the issue of opioid abuse and substance abuse in Orange County,” Dorosin said. “It’s a growing problem that we’ve seen that has impacts for our Department of Health, our Department of Social Services, the sheriff’s department, the jail, the courts – all of which impose significant costs on the county, and on the residents and the families that are impacted.”
Multiple lawsuits have been consolidated into one for the purpose of deciding whether the three biggest opioid distributors – Cardinal Health, AmerisourceBergen and McKesson Corp. – were negligent, engaged in racketeering and created a public nuisance by not working to curb opioid abuse.
Those companies own 85 percent of the market share and generate a total of over $300 billion in annual revenues.
“They were in the best position to know how many pills were being funneled and flooding really into our cities and into our counties,” Quezon said, “and under the Controlled Substances Act, they had a duty that if they had suspicious orders that they were immediately to stop the shipment and to alert the DEA of the suspicious orders, such that unethical doctors, these pill mills, black market pills that were being sold could be investigated and stopped.
“What we found is that they simply did not alert the DEA (about) any suspicious orders for year, after year, after year, and now here we are,” she said.
The lawsuit also targets opioid manufacturers Purdue Pharma, Teva Pharmaceuticals, Janssen Pharmaceuticals, Endo Health Solutions, Cephalon and Allergan, in particular for a widespread “chargeback” system that gave their distributors a substantial rebate in return for customer sales information. That data should have alerted manufacturers to suspicious orders, the attorneys alleged.
The manufacturers also are accused of advertising opioids as a safe substitute for non-addictive pain medications and downplaying the risks to grow public demand.
Durham County is still looking into whether or not to join the lawsuit, said Lowell Siler, Durham County attorney. The County Commissioners asked him to do research into the matter, and he plans to report to them soon, Siler said.
The Centers for Disease Control and Prevention reported in 2016 that roughly 42.1 opioid prescriptions were dispensed per 100 people in Orange County; 43.4 prescriptions in Chatham County; and 49.1 prescriptions in Durham County. The national average was 66.5 prescriptions per 100 people.
However, those numbers and the number of deaths from natural or semi-synthetic opioids, such as hydrocodone, had fallen or leveled off from their 2012 peak, suggesting some health-care providers have become “more cautious in their opioid prescribing practices,” CDC officials said.
The opioid companies have denied the claims and asked Ohio U.S. District Court Judge Dan Polster to delay the lawsuit until the Food and Drug Administration releases studies on long-term opioid risks and benefits.
The Healthcare Distribution Alliance, the national trade association representing distributors, said in a statement Wednesday that distributors report “every single opioid order to the DEA – whether it is suspicious or not.” Alliance officials also advocated for greater communication and coordination with the DEA to head off abuse and opioid diversion.
“The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders,” Alliance senior vice president John Parker said.
“Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated,” he said. “Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”
If the lawsuit is successful, state juries will award damages to individual governments. The money could help create a public education campaign about the dangers of pills, support the public response to opioid addiction, and provide treatment for addicts and opioid-addicted babies, Quezon said.
The attorneys will only be paid if there’s a settlement and are working with local governments to determine their opioid-related expenses.