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Opioid Litigation Media Update - 9/5/17
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Mora County files lawsuit against opioid manufacturers and distributors
Sep 1, 2017 | KRQE News 13
By Rebecca Atkins
A New Mexico county is suing drug makers, saying pharmaceutical companies are responsible for an overwhelming opioid epidemic in their community. It’s a problem that is costing them money and lives. -
Mora County sues opioid manufacturers, distributors
Sep 3, 2017 | Albuquerque Journal
By Megan Bennett
Mora County has filed suit against numerous major pharmaceutical manufacturers, accusing them of knowingly overdistributing the drugs at the center of the nation’s opioid crisis. -
Mora County joins lawsuit suing opioid makers over damages caused by prescription drugs
Sep 1, 2017 | The New-Mexican
By Bruce Krasnow
Mora County, claiming its taxpayers are unfairly bearing treatment costs of addicts, has become the first local government in the state to join a lawsuit seeking to collect money from the companies that manufacture addictive pain medicine known as opioids. -
Area towns consider joining lawsuit against opioid producers
Sep 4, 2017 | My Record Journal (CT)
By Jesse Buchanan
Area towns and cities, including Meriden, Southington, Cheshire and Plainville, could join a lawsuit filed by Waterbury against drug companies over the opioid epidemic. -
Dozens of Communities Consider Joining Opioid Lawsuit
Sep 5, 2017 | CT News Junkie
By Cyrus Dos Santos
Waterbury and possibly dozens of other Connecticut cities and towns are taking 11 pharmaceutical companies and three doctors to court for using deceptive practices in promoting opioids as a treatment for chronic pain. -
Connecticut communities join Waterbury in suing big pharma over opioid crisis
Sep 4, 2017 | MassLive
By Mary C. Serreze
Seven Connecticut communities affected by the opioid crisis will join the city of Waterbury in a lawsuit naming major pharmaceutical manufacturers. -
Darien considers joining municipal lawsuit against drug companies over opioid marketing
Sep 5, 2017 | Darien Times
By Susan Schultz
The Town of Darien is considering partnering with Waterbury in a class action lawsuit against major drug companies over marketing campaigns related to opioids and resulting addiction. -
Waterbury Sues Drug Companies Over Opioid Epidemic
Sep 5, 2017 | WNPR
By Harriet Jones
The city of Waterbury has filed a lawsuit accusing multiple pharmaceutical companies of causing the opioid addiction and overdose crisis. -
NY courts see wave of lawsuits against opioid makers
Sep 4, 2017 | CNHI
By Joe Mahoney
Pharmaceutical firms that produce pain-killing opiate drugs are facing a growing barrage of lawsuits from New York county governments seeking to hold them financially accountable for an epidemic of addiction and overdoses. -
Big Pharma Is Drowning In Lawsuits As US Addiction Crisis Worsens
Sep 5, 2017 | The Daily Caller
By Steve Birr
Connecticut is joining the growing body of states suing the major drug makers in America for igniting the opioid epidemic through fraudulent practices. -
Opioid death trends in area match state
Sep 3, 2017 | The Blade
By Lauren Lindstrom
SHARE TWEET SHARE EMAIL COMMENTS PRINT A new report detailing the number of Ohioans who died of accidental overdoses in 2016 confirms that trends seen last year in Lucas County and northwest Ohio are mirrored across the state — namely that the total deaths continue to rise, as does the prevalence of deadly synthetic opioids such as fentanyl and carfentanil. -
Pa. A.G. Shapiro visits Kennett to wage war on opioid crisis
Sep 1, 2017 | The Phoenix Reporter & Item
By Fran Maye
Determined to curb an opioid epidemic that is now the leading cause of death for all Americans under age 50, Pennsylvania Attorney General Josh Shapiro came to the borough Thursday morning to discuss the crisis with state lawmakers, municipal officials and law enforcement officers. -
U.S. and States Ramp Up Response to Opioid Crisis
Sep 5, 2017 | P&T Community
By Stephen Barlas
Opioid addiction has vaulted onto the front pages of the nation’s newspapers and to the top of Washington’s political agenda. Politicians in both parties and at all levels of government have raised what many call a “crisis” to a level of public attention it has never seen before. In mid-July, the Washington Post started a front-page story by citing 96 fatal overdoses in the first four months of 2017 in Cincinnati and quoted the city’s coroner saying the opioid epidemic ravaging western Ohio and scores of other communities along the Appalachian Mountains and the rivers that flow from it continues to worsen.1 Less than one week later, the Post ran another front-page story entitled, “A 10-Year-Old’s Overdose Death Reveals Miami Neighborhood’s Intense Struggle With Opioids.” -
Opioid Overdose Awareness in Southaven
Sep 5, 2017 | Desoto Times-Tribune (MS)
By Robert Lee Long
When a recovering opioid addict dies of an overdose death, the staff at Turning Point Recovery and Treatment Center in Southaven, takes it personally. -
Reforms From Bottom, Up
Sep 5, 2017 | Times-Tribune
By Editorial Board
A Bucks County community plans to confront the opioid epidemic by attempting to force pharmaceutical companies to provide compensation to address the crisis. -
KRQE News 13 at 5:30pm, 9pm, 9:30pm, 10pm, 3:30am, 5:30am
Sep 1, 2017 | KRQEDT2 (FOX)
By Albuquerque, NM
VIDEO LINK: http://app.criticalmention.com/app/#clip/view/29180727?token=cd85c9ba-7ecf-4799-8770-5909d885cc4e
Traditional Media Coverage
Broadcast Media Coverage
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Mora County files lawsuit against opioid manufacturers and distributors
Sep 1, 2017 | KRQE News 13
By Rebecca Atkins
A New Mexico county is suing drug makers, saying pharmaceutical companies are responsible for an overwhelming opioid epidemic in their community. It’s a problem that is costing them money and lives.
For Jennifer Weiss-Burke, opioid addiction hits close to home.
“It hit our family so fast that I never saw it coming,” she said.
Weiss-Burke’s son Cameron was an athlete, prescribed opioids for a sports-related injury and it led to an addiction. The addiction cost him his life. Weiss- Burke is now the Executive Director of Healing Addiction in Our Community.
“Opioids are a problem all over the United States, and New Mexico is no different,” said Weiss-Burke.
It’s such a big problem, there’s now a new push. States, counties, even cities, are taking legal action.
“Mora has courageously decided to lead here in New Mexico and has chosen to be the first county to file a lawsuit against the drug manufacturers, as well as specific doctors,” said Joshua Conaway, who represents Mora.
Conaway said in New Mexico, Mora is among the worst counties per capita when it comes to the opioid epidemic. The lawsuit Mora filed is alleging the companies and doctors are to blame.
“They have engaged in a marketing campaign that has basically marketed to doctors by overstating the effectiveness of this drug, while at the same time minimizing the problems that are associated with the drugs,” said Conaway.
Among the doctors listed in the lawsuit is one doctor who plead guilty in 2016 to illegally dispensing prescription pain killers.
The county is seeking damages for the cost of extra law enforcement, lost productivity, and health costs associated with the opioid problem.
People like Weiss-Burke, back the movement.
“I applaud them for taking a step in this direction and maybe it will make a difference,” she said.
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Mora County sues opioid manufacturers, distributors
Sep 3, 2017 | Albuquerque Journal
By Megan Bennett
The suit, which the county filed in state District Court on Aug. 28, has the same concept as recently undertaken litigation in other states including Ohio, Oregon, Connecticut and New York. It’s the first suit against opioid distributors filed by a New Mexico county.
Mora County attorney Michael Aragon coordinated on the 230-page lawsuit with Albuquerque-based attorney Joshua Conaway, whose firm specializes in wrongful death and personal injury cases against large corporations. Also, Conaway said he and his firm have partnered with a New York firm, Napoli Shkolnik PLLC, which is behind several similar New York and Ohio suits.
Conaway said Mora County is taking a “courageous” first step for the state.
“This case is about one thing: corporate greed,” the nearly 230-page suit starts. It says the drug companies and a group of physicians who have promoted the painkillers have “put their desire for profits above the health and well-being of Mora County consumers.”
The suit maintains that the companies have violated several laws, including the New Mexico Unfair Trade Practices Act. The companies have known the risks of opioids but instead promote the drugs for long-term use and downplay the risks to “expand the market for opioids and realize blockbuster profits,” the suit states.
The long list of defendants named in the suit include OxyContin distributor Purdue Pharma, Johnson and Johnson and Percocet distributor Endo Health Solutions.
Former Las Cruces doctor Pawan Kuman Jain, who pleaded guilty in 2016 to unlawfully providing opioids to New Mexico residents, is listed with four others from out of state whom the suit accuses of promoting opioids.
The suit maintains that Mora County residents traveled downstate to get drugs from Jain. When he pleaded guilty to two counts in February 2016, the former neurologist was facing nearly 80 unlawful dispensing charges and about 60 health care fraud charges.
According to the U.S. Attorney’s office, Jain’s charges were connected to four patients’ deaths. He has not yet been sentenced, according to court documents, but apparently remains in custody.
In recent news reports, some of the opioid manufacturing companies listed in Mora County’s suit have denied wrongdoing and say they advocate for the patients’ best interest.
Following the filing of a similar lawsuit in Waterbury, Conn., Purdue Pharma said in a Thursday statement to the Hartford Courant: “While we vigorously deny the allegations, we share local officials’ concerns about the opioid crisis and we are committed to working collaboratively to find solutions.”
Mora County Commission Chairman Paula Garcia said the county’s public health officials met with the commission about Mora’s “disproportionately” high overdose rates more than a year ago.
According to the state’s Department of Health, the county’s overdose rate was one of the state’s highest between 2011 and 2015 – 47.3 per 100,000 people. Mora County, with about 4,500 residents, had 14 drug overdose deaths in 2015, according to the suit.
The suit also says that in 2015 Mora County had 141 emergency room admissions related to heroin, a drug cited as popular with opioid addicts because it’s now less expensive and has a similar high.
Garcia said the county’s small size leaves it with little resources to combat the opioid crisis on its own. “In a rural area like ours, we need to get creative to how we’re going to respond to this,” she said.
In the last few months, Garcia said, county attorney Aragon made the commission aware of legal options, like the lawsuits filed elsewhere, that potentially could curb Mora County opioid abuse by going after the drug makers.
“There seems to be an overabundance of these drugs being manufactured, distributed and prescribed,” said Garcia. “If that’s happening and it’s hurt people in our community, those corporations should be held accountable.”
Conaway said damage amounts will be proven in the litigation. The county doesn’t have an estimated or desired figure in mind, according to Aragon.
Garcia said if any money is gained, it would go toward prevention, education and treatment programs for what she describes as an all-ages issue hurting her county’s future.
“I know parents who have had teenagers affected by this epidemic, and it’s really devastating,” said Garcia. “We need to be on the forefront of trying to address this problem.”
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Mora County joins lawsuit suing opioid makers over damages caused by prescription drugs
Sep 1, 2017 | The New-Mexican
By Bruce Krasnow
Mora County, claiming its taxpayers are unfairly bearing treatment costs of addicts, has become the first local government in the state to join a lawsuit seeking to collect money from the companies that manufacture addictive pain medicine known as opioids.
The Mora County commissioners voted unanimously to retain the firms of Napoli Shkolnik of New York and Fadduol, Cluff, Hardy & Conaway of Albuquerque to sue on behalf of county taxpayers and seek compensation from pharmaceutical companies. The commissioners’ claim the county is entitled to monetary damages because of the harm and public expense caused by prescription drugs, including Oxycontin and Percocet.
The 235-page lawsuit was filed this week in the state District Court in Las Vegas, N.M., and has been assigned to Judge Abigail Aragon.
“The lawsuits seek to recover money that the county had to expend for substance abuse programs, extra law enforcement and a whole host of other costs associated with opioid overdoses in New Mexico,” said Joshua K. Conaway, an Albuquerque attorney on the case. “Mora County has chosen to take a leadership role in the state with the opioid epidemic.”
The case names 20 of the largest drugmakers, including Purdue Pharma, Johnson & Johnson, Cardinal Health, Teva Pharmaceuticals and McKesson Corp. Advocates claim the litigation is similar to that filed by state governments against Big Tobacco, which resulted in a $200 billion settlement paid over decades by major companies. The money has helped to support basic government programs and fund cancer research and smoking cessation programs.
For their part, the drug companies say they are providing medicine approved by the U.S. Food and Drug Administration that must be prescribed by a physician. When abuse occurs, they say, it is because addicts are not following the label guidelines or gain access to their product illegally.
The companies say this case is different from the tobacco litigation in which smokers bought cigarettes over the counter and were unaware of the addiction level.
Attorney Joseph L. Ciaccio of Napoli Shkolnik said his firm now represents two dozen governments, including those of New York state, Ohio, West Virginia, Maine and New Hampshire. All the cases seek to prove that the pharmaceutical firms were deceptive about the potency of their products. He said opioid medicines were intended to relieve postsurgical pain and for end-of-life care.
Instead, he said, the manufacturers “weren’t honest about the addictive nature of the pills,” and “convinced the medical community they could be used for permanent care for anyone with any type of ache and pain. And now we are seeing the effects of that.”
A news release by the lawyers carried a statement from Mora County Commission Chairwoman Paula A. Garcia. “Mora County is proud to lead the charge in New Mexico in this groundbreaking litigation,” she said. “The opioid epidemic has caused devastation, touched virtually every citizen’s life and certainly has caused the county to incur expenses and utilize resources needlessly.”
Of New Mexico’s 33 counties, Mora’s population of 4,500 ranks it 27th.
Recent data released by the state Department of Health indicates the overdose death rate in the state fell to 24.8 deaths per 100,000 in 2015, down from 26.8 in 2014.
New Mexico ranked second in deaths nationally in 2014 and 42nd in 2015. The national data for 2016 has not yet been released by the U.S. Centers for Disease Control.
Though Mora County’s overdose deaths previously were above the national and state average, state data shows no deaths in either 2015 or 2016.
Mora County in 2014 was also at the forefront of an effort by groups to use local land-use and water-quality regulations to prohibit fracking, a technique for oil and gas extraction.
Within months, a private-property owner, two companies and the Independent Petroleum Association of New Mexico filed a lawsuit in federal court, claiming the ordinance infringed on property rights and violated the U.S. Constitution. A subsidiary of Royal Dutch Shell filed a separate lawsuit over the ban, seeking damages.
A U.S. district judge ruled in 2015 that Mora County’s oil and gas ban was unconstitutional and invalid.
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Area towns consider joining lawsuit against opioid producers
Sep 4, 2017 | My Record Journal (CT)
By Jesse Buchanan
Area towns and cities, including Meriden, Southington, Cheshire and Plainville, could join a lawsuit filed by Waterbury against drug companies over the opioid epidemic.
New York and Waterbury law firms are representing the city of Waterbury against a host of pharmaceutical manufacturers as well as doctors that have promoted opioid painkillers. The lawsuit served this week argues that the firms and doctors misrepresented the addictive nature of the drugs.
In 2007 Purdue, the manufacturer of OxyContin, settled criminal and civil charges against it for “misbranding” the opioid, according to the lawsuit. The company settled for $635 million.
Waterbury officials are hoping to receive reimbursement from Purdue and other companies for expenses incurred in treating opioid addiction, overdoses and other effects. The city is the only plaintiff at the moment but representatives from municipalities in the area met this week about the lawsuit.
Leaders in Meriden, Southington and Cheshire are considering joining the legal action.
Michael Quinn, Meriden’s corporation counsel, said the city has to weigh the costs and benefits of participating. The City Council would also likely need to weigh in on whether to join the lawsuit.
Jim Hartley, an attorney with Drubner, Hartley & Hellman of Waterbury, said there’s no cost to towns and cities. If successful, his firm and New York-based Simmons Hanly Conroy would be paid. If not, the firms would absorb the cost of litigation.
“We’re going to bear all the costs. At the end of the day if we don’t prevail, we still bear the costs,” Hartley said.
Paul Hanly, an attorney with Simmons Hanly Conroy, said the suit’s basis was the same as in the 2007 settlement.
“The companies led by Purdue Pharma, which is a Connecticut company, created a campaign of disinformation about the addiction properties of opioids,” Hanly said.
Purdue is based in Stamford. A representative from the company couldn’t immediately be reached for comment.
In addition to money for addiction-related services, Hanly is hoping for pharmaceutical companies to contribute funds toward addiction prevention efforts. Such a settlement would be similar to those with tobacco companies.
“We would be looking for the same thing,” he said. “A component of any resolution would have to be not only money for the past but a continuing commitment to these communities.”
Health officials have blamed increased opioid addiction for a rise in heroin use among those no longer able to buy painkillers.
Cheshire Town Manager Michael Milone said police, fire and health officials are scheduled to give a presentation on opioid addiction at the Sept. 12 Town Council meeting. He’s not sure if Cheshire should join the lawsuit but he is going to compile addiction-related expenses before the meeting so the council can make a decision.
Unlike Waterbury, which runs a methadone clinic, Milone wasn’t sure how many identifiable expenses Cheshire could document.
“That’s something that’s going to be very, very difficult to determine and identify,” he said. “It’s not to say that hidden somewhere there isn’t some expense.”
Cheshire has had overdoses, some fatal, and Milone said he’s supportive of any efforts to combat addiction.
Southington Town Manager Garry Brumback said the town is also considering whether to join the lawsuit. Town Attorney Mark Sciota attended the meeting in Waterbury this week.
“At this particular point, it appears as though we’re going to act as part of a municipal coalition,” Brumback said.
Hanly said the suit wouldn’t be a class action, but that towns and cities could join as additional plaintiffs.
The first hearing on the case won’t be held for months, according to Hartley. Litigation for the case settled in 2007 took four years.
Plainville Town Manager Robert E. Lee said he’ll bring the question of whether to join the lawsuit before the Town Council later this month and recommend that the town do so.
“Plainville is not immune to the opioid crisis in Connecticut,” he said. “We have had several deaths in our community and we have seen a marked increase in the town’s self-insurance prescriptions related to opioids.”
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Dozens of Communities Consider Joining Opioid Lawsuit
Sep 5, 2017 | CT News Junkie
By Cyrus Dos Santos
Waterbury and possibly dozens of other Connecticut cities and towns are taking 11 pharmaceutical companies and three doctors to court for using deceptive practices in promoting opioids as a treatment for chronic pain.
“Communities throughout Connecticut have been suffering the devastating effects of this opioid epidemic for years and we in Waterbury believe it is time to take a stand,” Waterbury Mayor Neil O’Leary said last week before the lawsuit was filed.
During a press conference last week, O’Leary acknowledged the destruction the opioid epidemic has caused throughout the state. Leaders from more than 20 communities, who are considering joining the lawsuit, joined O’Leary for the press conference.
“Bristol decided that we are going to join it,” Bristol Mayor Ken Cockayne said last Friday.
Bridgeport is another community which decided it would join the complaint.
“We have a moral obligation to all of our citizens and residents and that these drug companies must be held accountable,” Bridgeport Mayor Joseph Ganim said.
Milford is also joining the lawsuit.
“It’s something that we want to push back on,” Milford Mayor Benjamin Blake said last week. “It’s something that we feel strongly that we need to address from all angles. This is the legal angle.”
The city of Milford allocates 20 percent of its budget for health care costs. Last year, that percentage came to approximately $40 million.
“We know it goes beyond just the medical costs,” Blake added. “Not only the cost from a financial standpoint but, even more so, the human toll that this epidemic extracts.”
In 2016, Waterbury, according to the complaint, expended $1.4 million on opioid prescriptions for city employees, a 212 percent increase from 2013.
The complaint states that the pharmaceutical companies “knew or should have known that, with prolonged use, the effectiveness of opioids wanes, requiring increases in doses to achieve pain relief and markedly increasing the risk of significant side effects and addiction.”
In total, from 2002 through 2015, opioid overdose deaths, including heroin, have risen 280 percent in the U.S., according to findings from the National Institute on Drug Abuse. As of 2017, the lawsuit states that “Connecticut rose from ranking 50th in drug overdose deaths to 12th place.”
The complaint, filed in Waterbury Superior Court, names Purdue Pharma L.P., the maker of OxyContin, as the lead defendant in the case. A spokesman for the company did not respond to requests for comment.
Other defendants in the lawsuit are: The Purdue Frederick Company, Inc.; Teva Pharmaceuticals USA, Inc.; Cephalon, Inc.; Johnson & Johnson; Janssen Pharmaceuticals, Inc.; Ortho-McNeil-Janssen Pharmaceuticals, Inc.; Janssen Pharmaceutica, Inc.; Endo Health Solutions Inc.; Endo Pharmaceuticals, Inc.; Dr. Perry Fine; Dr. Scott Fishman and Dr. Lynn Webster.
States, counties, and municipalities have filed similar lawsuits against pharmaceutical companies.
“Waterbury is the first Connecticut city to join the growing list of municipalities around the country that have concluded that the defendant drug companies must be held responsible for their conspiratory and fraudulent actions and the injuries and costs that have resulted from the opioid epidemic,” Paul J. Hanly Jr., of Simmons Hanly Conroy, said.
The New York-based law firm has filed similar complaints on behalf of Duchess, Broome, Erie, Orange and Suffolk Counties in New York. There are the two filed in California and one in Chicago, two in West Virginia, and another in the city of Everett, Washington, and several more in the works.
The lawsuit states that Waterbury has incurred annual costs in the millions, “including payments for prescription opium-like painkillers (‘opioids’), which are manufactured, marketed, promoted, sold, and/or distributed by the Defendants, as well as payment for the treatment of addiction to opioids.”
“A 2016 Centers for Disease Control and Prevention study,” the lawsuit adds, “estimated the national economic impact of prescription opioid overdoses, abuse and dependence to be $78.5 billion dollars annually.”
By filing legal action as a municipality, rather than the state as a whole, Hanly believes cities like Waterbury will finally receive restitution.
Reflecting on the $242 billion settlement with the tobacco industry, Hanly stated that “virtually none of that money broke down to the local towns or cities in the affected states. This is” he added, “a safer way to ensure that at the end of the day the city of Waterbury and any other city is actually gonna get some money if we are successful in the litigation.”
One of the claims is that each manufacturer had knowledge of “limited” short-term uses, which capped off at 90 days. These findings, according to the complaint, were confined to “managed settings (e.g. hospitals).”
The lawsuit claims the defendant’s mislead the public, as well as providers, about the dangers involved with long-term opioid use by creating a false sense of security “in the minds of medical professionals and members of the public that would encourage the use of opioids for longer periods of time and to treat a wider range of problems, including such common aches and pains as lower back pain, arthritis, and headaches.”
According to the complaint, the city seeks relief, including compensatory and punitive damages, for the millions of dollars it spends each year to combat the public nuisance created by the drug companies’ deceptive marketing campaign. The Waterbury-based law firm Drubner, Hartley and Hellman is joining Simmons Hanly Conroy as co-counsel in the lawsuit.
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Connecticut communities join Waterbury in suing big pharma over opioid crisis
Sep 4, 2017 | MassLive
By Mary C. Serreze
Seven Connecticut communities affected by the opioid crisis will join the city of Waterbury in a lawsuit naming major pharmaceutical manufacturers.
Bristol, Bridgeport, New Milford, Naugatuck, Oxford, Wolcott and Roxbury all agreed Thursday to take action, the Hartford Courantreports. Waterbury mayor Neil O'Leary predicted another 15 to 20 communities will sign on as co-plaintiffs.
The suit claims drug manufacturers deliberately misrepresented the facts about prescription painkillers, triggering a nationwide addiction epidemic.
The communities join a growing number of cities and states that are suing pharmaceutical companies over the impacts of opioid addiction. The cases, largely filed in state courts, cite the costs of education, prevention, emergency response, treatment, and broken families.
Thirty-three people died of overdoses in Waterbury last year, a number that tripled since 2012. The city has already had 32 opioid-linked deaths this year. Attorneys at a Waterbury press conference told reporters the case could end in a settlement in "the hundreds of millions," according to the Connecticut newspaper.
Waterbury's suit alleges that Purdue Pharma, Teva Pharmaceuticals USA, Johnson & Johnson, Endo Health Solutions used sophisticated, coordinated and deceptive marketing to persuade pharmacists, physicians and patients that opioid painkillers were safe and effective over long periods of time for relatively minor ailments.
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Darien considers joining municipal lawsuit against drug companies over opioid marketing
Sep 5, 2017 | Darien Times
By Susan Schultz
The Town of Darien is considering partnering with Waterbury in a class action lawsuit against major drug companies over marketing campaigns related to opioids and resulting addiction.
Six other municipalities in Connecticut have already committed to partner with Waterbury in the case, including New Milford, Naugatuck, Oxford, Bristol, Wolcott, Roxbury and Bridgeport.
Darien First Selectman Jayme Stevenson, along with Patti Gaug, from the town counsel office of Curtis Brinckerhoff & Barrett, attended an informational meeting in Waterbury on Thursday, Aug. 31.
“We learned that suit, filed today by the City of Waterbury, is crafted after a lawsuit already pending in Suffolk County, New York,” Stevenson said.
She said she is seeking a copy of that lawsuit that contains “illuminating information” regarding several big pharmaceutical companies, including Purdue Pharma. Stevenson said she has some further thought and work to put into the concept before presenting the idea to her board.
Waterbury alone has already had nearly 40 overdose deaths already this year. In January, David Knauf, Darien’s health director, said the misuse of prescription medication has become the number one cause of death from drug overdose in the country, and Connecticut is among the top 10 states for illicit drug dependence among young adults ages 18 to 25.
Following the meeting, Stevenson provided The Darien Times with more information regarding the suit.
The legal team working on the Waterbury, et al lawsuit is Drubner Hartley & Hellman, LLC and Simmons Hanly Conroy, LLC.
The Waterbury claim (suit) is against Purdue Pharma LP, Purdue Pharma Inc, The Purdue Frederick Company Inc, Teva Pharmaceuticals USA Inc., Cephalon Inc, Johnson & Johnson, Janssen Pharmaceuticals Inc, Ortho-McNeil-Janssen Pharmaceuticals Inc, Janssen Pharmaceutica Inc., Endo Health Solutions Inc., Endo Pharmaceuticals Inc., Dr. Perry Fine, Dr. Scott Fishman and Dr. Lynn Webster – alleging that “these defendants have harmed the City of Waterbury and its residents through an aggressive marketing campaign that sought to, and did, change long-standing medical prescribing practices that dictated that opioids should only be used short-term or for terminal illnesses because of their highly addictive nature. The City’s complaint alleges that the defendants orchestrated a campaign that falsely presented opioids as safe and effective for long-term use for chronic pain, even though the defendants knew that the promotion of opioids for these purposes was not warranted and would lead directly to increased costs for patients, healthcare insurers and payers such as the City of Waterbury.”
Stevenson said the hopeful outcome of the suit is not only a financial settlement to help reimburse municipalities for the extraordinary costs incurred fighting the opioid addiction epidemic, but also to have the defendants accountable to help with opioid education, treatment programs, prescriber education and any other outcomes the municipalities deem necessary and appropriate.
The law firms are working on a contingency basis only and will be reimbursed from any ultimate settlement. No costs will be incurred by cities and towns.
In 2016, Lt. Jeremiah Marron of the Darien Police Department said while tough to compare statistics to determine whether Darien has a bigger opioid problem than its neighbors, “opiate addiction can be attributed to most of the crimes and cases we are dealing with.”
“We’re fighting the heroin and pill problem — we’re very aware there’s a prescription pill problem,” Marron told The Darien Times last year. Marron also pointed out the problem appears to be New England-wide and there hasn’t appeared to be any statistical reason why the problem is worse in that region.
From 2014 to 2015, heroin deaths increased by 27% in Connecticut and of the 723 people who died of an overdose in 2015, 415 were heroin related and another 107 were related to fentanyl, a powerful opiate that drug dealers have been lacing heroin with to make it more potent.
Experts point to the over-prescribing of opioids in 2012, noting 259 million prescriptions were written for opioids – enough to give every adult in the U.S. their own bottle of pills — as one of the leading causes of the current crisis.
Stevenson said in her own research she has noted other municipalities and states have taken similar action, including South Carolina, New Hampshire, Birmingham, Alabama and Cincinnati, Ohio.
Culpability on the part of big pharma can be attributed to what some consider deceptive marketing of opioid painkillers and settlements have been awarded in other cases.
In its June 2017 story, “Are Pharmaceutical Companies to Blame for the Opioid Epidemic?” The Atlantic noted “significant evidence that pharmaceutical companies may have engaged in some activities that led to the opioid crisis.”
The story mentioned a Los Angeles Times investigation into Purdue Pharma, that found the drug maker, which marketed OxyContin as relieving pain for 12 hours, knew that the drug wore off before that time period. Since the drug didn’t last as long as promised, some patients suffered withdrawal, which led them to become addicted.
• Read the Los Angeles Times investigation: “You want a description of hell? Oxycontin’s 12-hour problem”
The story noted others that filed similar lawsuits, including Illinois, Mississippi, four counties in New York, and Santa Clara and Orange Counties in California, Everett, Washington, and the Cherokee Nation.
On Aug. 3, U.S.A. Today reported that Insys Therapeutics Inc said it was taking a $4.5 million charge in connection with resolving a lawsuit by Illinois’ attorney general claiming it deceptively marketed a fentanyl-based cancer pain drug for off-label uses.
It is difficult to determine how many actual overdoses in Darien, especially those that are treated and released, because hospitals don’t report those back to the towns from where they originate. They are recorded as accidental poisonings — a policy that Stevenson also hopes will change to become more accurately representative of an overdose incident.
Earlier this year, State Rep. Terrie Wood, who represents part of Darien and Rowayton, introduced several pieces of state legislation regarding the distribution of opioids in Connecticut.
Wood said “two of them got rolled into the big bill on opioids. Rather than to do a batch of stand alone bills, it is typical that all legislation relating to the same subject gets rolled into one big bill.”
They were signed into law Thursday. These bills:Create a process for patients to request they not be prescribed opioids. Prescribers ( doctors, nurse practitioners, physician assistants must discuss with patients risks associated with opioid use.
One that didn’t pass would have required pill manufacturers to package opioids in blister packs, making them easier to keep track of and count. Wood said she hopes to have that pass next year.
Stevenson has yet to ultimately make up her mind on whether she will recommend Darien join the lawsuit.
“There might be other ways other than litigation. We could encourage big pharma to partner to be part of the solution. I am not always in favor of litigation being the only way to go, but I want to keep an open mind,” Stevenson said.
Stevenson also said she welcomes feedback from Darien residents on the possible participation in the lawsuit. She can be reached at jstevenson@darienct.gov or 203-656-7338.
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Waterbury Sues Drug Companies Over Opioid Epidemic
Sep 5, 2017 | WNPR
By Harriet Jones
The city of Waterbury has filed a lawsuit accusing multiple pharmaceutical companies of causing the opioid addiction and overdose crisis.
The city’s attorney, Jim Hartley, said the municipality is seeking monetary damages.
"They have enormous costs as a result of opioid prescription increases, and they have exorbitant opioid addiction treatment costs," he told WNPR. "And their view is this crisis is a creation of the large pharmaceutical companies."
The suit alleges a conspiracy by companies including Stamford-based Purdue Pharma, the maker of Oxycontin.
Hartley said the companies’ deceptive marketing aimed to ramp up prescriptions without heed to the potential effects.
“It’s an intentional scheme, really, to change the standard of care, and they did change the standard of care in medicine, to recommended physicians continue to prescribe opioids for pain management, when there [was] no medical literature that had examined the long term effect,” he said.
Waterbury officials said Bristol, Bridgeport, New Milford, Naugatuck, Oxford, Wolcott, and Roxbury are among 30 Connecticut municipalities that are considering joining the suit.
Similar lawsuits have been filed by other local governments around the country this year. None have yet gone to trial.
In addition to Purdue Pharma, the suit names Teva Pharmaceuticals USA, Johnson & Johnson, and Endo Health Solutions.
Purdue has released a statement saying it will fight the lawsuit. "While we vigorously deny the allegations, we share local officials' concerns about the opioid crisis and we are committed to working collaboratively to find solutions," the company stated.
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NY courts see wave of lawsuits against opioid makers
Sep 4, 2017 | CNHI
By Joe Mahoney
Pharmaceutical firms that produce pain-killing opiate drugs are facing a growing barrage of lawsuits from New York county governments seeking to hold them financially accountable for an epidemic of addiction and overdoses.
The lawsuits contend that the companies have made hefty profits by using deceptive marketing techniques to increase the sales of their pills to treat such ailments as arthritis, lower-back pain and headaches.
At least nine New York counties have individually filed lawsuits against various manufacturers.
And more are contemplating retaining private law firms that specialize in tort litigation to bring similar cases, among them Clinton, Niagara and Otsego counties, according to local officials.
CONSIDERING SUITS
Clinton County Administrator Michael Zurlo acknowledged his county has been approached by law firm representatives seeking to be retained to commence legal actions against the drug companies.
He said the County Legislature has instructed the county attorney, James Coffey, to delve into the matter but has not yet authorized a lawsuit.
Niagara County may be among the next batch of local governments to join the effort, officials said.
County Legislator David Godfrey (R-Burt) said he believes the manufacturers did not do enough to educate the public on the risks of taking prescribed opioids.
"If you're marketing any type of product which is proven to be harmful or life-threatening,” he said, “I would think the companies would have the responsibility to make that widely and openly known."
CONTINGENCY BASIS
The lawsuits link the current heroin epidemic to the marketing practices of the drug companies.
They maintain that many people who become addicted to such prescription drugs as Oxycontin and Percocet turn to heroin as an alternative when their prescription pills cannot be acquired.
"Everyone is realizing that their counties are being economically decimated by this problem," said Hunter Shkolnik, a partner in the Manhattan law firm Napoli Shkolnik, one of two firms that have been in talks with officials in Otsego County.
The lawsuits are being brought by two of the most populous New York counties outside New York City — Suffolk and Nassau counties on Long Island — as well as some with relatively small populations.
Schuyler County, with a population of 18,300, announced its lawsuit in tandem with Napoli Shkolnik on Aug. 17.
“By voting to go forward with litigation, the County Legislature hopes to lessen the burden to taxpayers and seeks to hold manufacturers and distributors responsible for their role in the opioid epidemic," Schuyler County Administrator Tim O'Hearn said.
He said the lawsuit was filed at no cost to his county, as the law firm is working on a contingency basis that will cover all costs arising from the lawsuit.
Otsego County Attorney Ellen Coccoma said members of her county board are expected to hear presentations from representatives of both Shkolnik's firm and a second firm handling the suits for several counties, Simmons Hanly Conroy, also based in New York City.
DENY ALLEGATIONS
The companies being sued have denied the allegations made against them. They include Purdue Pharma, L.P. and Janssen Pharmaceuticals Inc., a subsidiary of Johnson & Johnson.
William Foster, a spokesman for Janssen, said in an emailed statement that his company recognizes that "opioid abuse is a serious public health issue that must be addressed.
"At the same time," he added, "we firmly believe the allegations in these lawsuits are both legally and factually unfounded. Janssen has acted responsibly and in the best interests of patients and physicians with regard to these medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label."
Foster also said Janssen provides doctors with "complete and accurate information on how to prescribe our opioid medications."
'LONG OVERDUE'
As recovering addict Dylan Clark sees it, such lawsuits are long overdue.
Clark, 38, founded an addiction support group in Oneonta called Clean Is The New Dirty. Clark, who now resides in Utica, traced his addiction to a prescription to hydrocodone after he injured his back in a car accident when he was 17 years old.
"What I like about these lawsuits is they hurt the drug companies right where it hurts —in the pocketbook," he said. "I'm hoping it will cause them to be less reckless with their product in the future."
A 2016 report by the U.S. Centers for Disease Control and Prevention pegged the economic tab for prescription opioid and heroin abuse nationally at $78.5 billion annually, with taxpayers paying for nearly a quarter of that sum.
LIKE TOBACCO SUITS
The litigation being brought by a growing number of New York counties as well as several states and county governments across the nation is reminiscent of the lawsuit brought by 48 states against Big Tobacco in 1998, Shkolnik said.
He said the tobacco litigation produced a windfall for the states when it was settled. By initiating their own lawsuits against the opioid makers, he noted, the counties will get payments directly from the companies, should they prevail in court.
"We are trying to keep these cases as individual cases (in state courts) in the venues where the people are affected," Shkolnik said.
He said it was too early to predict whether the lawsuits will result in a settlement similar to the national one in the tobacco litigation.
CLAIMS FRAUD
Shkolnik said documents assembled by his firm show that fraud was used in marketing prescription opioids.
He said his firm worked with retired federal narcotics investigators to document the practices of the drug companies and distributors.
"I'd like to see the facts come out in a jury setting where the press can see the documents," he said. "I really, really hope these dirty documents get out to the public."
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Big Pharma Is Drowning In Lawsuits As US Addiction Crisis Worsens
Sep 5, 2017 | The Daily Caller
By Steve Birr
Connecticut is joining the growing body of states suing the major drug makers in America for igniting the opioid epidemic through fraudulent practices.
Officials from seven municipalities in the state joined with the city of Waterbury on Thursday to file a lawsuit against four pharmaceutical companies seeking damages for the havoc created in the state by painkillers. A report from the state Office of the Chief Medical Examiner says opioid deaths are on pace to rise again in 2017, estimated to claim 1,000 lives by the end of the year, reports Hartford Courant.
The lawsuit so far includes Bristol, Bridgeport, New Milford, Naugatuck, Oxford, Wolcott and Roxbury. Waterbury Mayor Neil O’Leary said Thursday he expects an additional 15 to 20 towns in the state to join the legal effort. (RELATED: How One Painkiller Ignited The Addiction Epidemic)
“We’re all dealing with this opioid crisis, epidemic – it’s absolutely having devastating impacts on every city and town in the state of Connecticut and across the country,” O’Leary said Thursday, according to Hartford Courant.
The lawsuit targets Purdue Pharma, Teva Pharmaceuticals USA, Johnson & Johnson and Endo Health Solutions, along with a number of subsidiaries. They allege that pharmaceutical companies knowingly marketed false information on their drugs, leading unsuspecting users down the hole of addiction.
“While we vigorously deny the allegations, we share local officials’ concerns about the opioid crisis and we are committed to working collaboratively to find solutions,” a representative for Purdue Pharma said in a statement to the Hartford Courant.
Lawsuits are mounting against the largest drug makers in the country for their alleged complicity in sparking the opioid crisis through dishonest advertising. The law firm Simmons Hanly Conroy LLC is spearheading cases in New York, as well as two lawsuits in California, two in West Virginia, one in Chicago and one in Washington state.
An Illinois county hit hard by the opioid crisis launched a lawsuit against the pharmaceutical industry July 1. This is the second lawsuit leveled against major drug makers by officials in Illinois, adding to more than 25 civil cases that have already been filed this year against the top pharmaceutical companies and their distributors.
Brendan Kelly, the state attorney for St. Clair County, Ill., filed a 159-page lawsuit April 20 against Purdue Pharma and Abbott Laboratories, also accusing the company of consumer fraud and profiting off deception.
Deputy Attorney General Rod Rosenstein said June 6 that drug deaths in the U.S. experienced the largest increase in recorded history in 2016, claiming more than 60,000 lives. He notes that data suggests deaths from opioids and other drugs will continue to increase in 2017.
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Opioid death trends in area match state
Sep 3, 2017 | The Blade
By Lauren Lindstrom
A new report detailing the number of Ohioans who died of accidental overdoses in 2016 confirms that trends seen last year in Lucas County and northwest Ohio are mirrored across the state — namely that the total deaths continue to rise, as does the prevalence of deadly synthetic opioids such as fentanyl and carfentanil.
Unintentional drug overdoses killed 1,000 more people in Ohio in 2016 than the previous year — 4,050 compared with 3,050 in 2015 — according to a report last week from the Ohio Department of Health.
Fentanyl and related drugs were involved in 58.2 percent of all deaths, up from 37.9 percent in 2015. The powerful synthetic opioid, which is up to 50 times more potent than heroin, has sharply increased in recent years. It was the cause of just 4 percent of overdoses in Ohio in 2013.
Heroin deaths remained flat and prescription deaths declined for the fifth consecutive year, down to 564 — the fewest since 2009 — the report shows.
“The continued increase in opioid-related deaths reaffirms that we still have much work to do, but Ohio is seeing important progress in reducing the number of prescription opioids available for abuse and prescription-related overdose deaths,” said a statement from Dr. Mark Hurst, medical director of the Ohio Department of Mental Health and Addiction Services and interim medical director for the state health department. “This progress is significant because prescription opioid abuse is frequently a gateway to heroin and fentanyl use later on.”
A new rule took effect Thursday limiting doctors to prescribing seven days worth of opioids for adults to treat acute pain; prescriptions for children are limited to five days. Gov. John Kasich announced the change in March.
Some of the highest death rates from 2011 to 2016 were in southwestern counties such as Butler and Montgomery counties, where death rates were 40.5 and 42.5 per 100,000 people, respectively.
In Lucas County, the death rate was 24.1 per 100,000 people, the highest in the region. It was 11.1 in Wood and 17.4 in Fulton, according to the report.
The 2016 Ohio numbers confirm what Toledo-area officials are seeing is also happening elsewhere.
A June report from the Lucas County Coroner’s Office revealed fentanyl, for the first time, is behind more overdose deaths than heroin in a 21-county region of northwest Ohio and southeast Michigan. The local figures show overall deaths continue to increase with the rise of potent and synthetic opioids that can be deadly in very small quantities.
The new report also affirms the local need for continued prevention and treatment efforts, said Scott Sylak, executive director of the Lucas County Mental Health and Recovery Services Board.
“We continue to invest in these strategies understanding that we have to be in it for the long haul,” he said.
He pointed to several new programs or services that began in Lucas County in recent months, including new inpatient detox centers at the University of Toledo Medical Center and Unison Health, ambulatory detox services at Zepf Center and New Concepts, and the Northwest Ohio Syringe Services needle exchange run through the Toledo-Lucas County Health Department.
“There isn’t an easy or quick answer,” he said. “These are very difficult social questions that don’t lend themselves well to a quick answer.”
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Pa. A.G. Shapiro visits Kennett to wage war on opioid crisis
Sep 1, 2017 | The Phoenix Reporter & Item
By Fran Maye
Determined to curb an opioid epidemic that is now the leading cause of death for all Americans under age 50, Pennsylvania Attorney General Josh Shapiro came to the borough Thursday morning to discuss the crisis with state lawmakers, municipal officials and law enforcement officers.
“I need to know what’s happening on the ground and how my office can assist in the local efforts,” said Shapiro, who has visited eight counties in the past two days. “We need to have a collaborative, multi-disciplinary approach to deal with the number one public health threat in Pennsylvania - the heroin and opioid epidemic. And these forums provide a great opportunity.”
The discussion, which coincided with International Overdose Awareness Day, took place at Kennett Fire Company’s Red Clay Room, and included almost the entire Chester County legislative delegation, state Rep. Steve Barrar, state Rep. John Lawrence, state Rep. Harry Lewis, state Rep. Becky Corbin, state Rep. Warren Kampf, and state Rep. Carolyn Comitta. Also in attendance were local police chiefs from throughout Chester County and Chester County Commissioners Kathi Cozzone and Terence Farrell.
“I can’t think of a family that hasn’t been affected by this,” said Barrar, R-160 of Concord.
New Garden Police Chief Gerald Simpson said more efforts must be put into educating the younger set.
“We had five (opioid-related) deaths last year,” Simpson said. “If I had five fatal accidents in one year, my community would be outraged and would ask me what I plan to do about it.”
Simpson said 25 percent of the opioid-related cases his department worked on last year resulted in death.
“That’s a scary number,” he said.
Shapiro told the panel that the crisis is taxing law enforcement and first responders in a significant way. He said police sometimes return to administer Narcan to the same person multiple times. There were 4,642 drug-related deaths in Pennsylvania last year, and if nothing is done, that number will skyrocket, he said.
Dinniman said he was glad to see Shapiro make the opioid crisis a priority.
“It was a productive and comprehensive discussion,” Dinniman said. “At the end of the day, solving the opioid crisis is not going to be a one-agency issue. Rather, it’s is going to take multi-pronged and cooperative effort between law enforcement personnel, public health officials, educators and others. And one of this morning’s overriding themes was how can we take what is working in Chester County and replicate it throughout the state.”
Shapiro cited his office’s and other local and state law enforcement departments’ efforts to crack down on illegal drug dealers amid the continued use and abuse of prescription medicine.
“We’ve arrested 844 drug dealers since I took office eight months ago. We could do that every day on and on, but at the end of the day it’s not going to solve it,” he said. “Prescription drugs are the root cause of so many of these problems.”
He also discussed efforts to deactivate and dispose of unwanted or unused prescription drugs, holding opioid manufacturers accountable, and working to improve access to addiction treatment and recovery options.
Cozzone expressed concerns about young people and students being prescribed opioids for sports injuries.
Dinniman discussed Senate Bill 535, legislation that calls for opioid awareness and addiction prevention education in Pennsylvania schools. That bill was incorporated in the Pennsylvania School Code, which recently passed the Senate.
Comitta, who said she plans to talk to the local medical community about the problem, said the roundtable discussion is a great start to eradicating the problem.
“We all need to put our heads together to figure out how to combat this very complicated, very distressing opioid epidemic,” Comitta said. “It’s multi-faceted and it will take every level of government and every level of law enforcement. This is a public health crisis.”
Lawrence said here is bipartisan support among local lawmakers to attack the opioid problem.
“There are a lot of challenges, but we are talking about people’s lives,” Lawrence said. “I can tell you there is a united front on this and we will move forward. It’s an issue that all of us are searching for solutions.”
Thursday morning’s discussion was one of several events involving combating opioid abuse in Chester County that day. Later that afternoon, Dinniman joined Shapiro to announce a series of roundtable discussions at Pennsylvania colleges and institutes of higher education aimed at addressing drug and alcohol abuse, mental health and sexual assault on campus.
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U.S. and States Ramp Up Response to Opioid Crisis
Sep 5, 2017 | P&T Community
By Stephen Barlas
Opioid addiction has vaulted onto the front pages of the nation’s newspapers and to the top of Washington’s political agenda. Politicians in both parties and at all levels of government have raised what many call a “crisis” to a level of public attention it has never seen before. In mid-July, the Washington Poststarted a front-page story by citing 96 fatal overdoses in the first four months of 2017 in Cincinnati and quoted the city’s coroner saying the opioid epidemic ravaging western Ohio and scores of other communities along the Appalachian Mountains and the rivers that flow from it continues to worsen.1Less than one week later, the Post ran another front-page story entitled, “A 10-Year-Old’s Overdose Death Reveals Miami Neighborhood’s Intense Struggle With Opioids.”
“Opioid addiction and the resulting overdoses and deaths … [are] in my view, the toughest public health challenge that we face at FDA,” said Scott Gottlieb, MD, Commissioner of the Food and Drug Administration (FDA), who in July announced new requirements for risk evaluation and mitigation strategy (REMS) programs for opioids, including new training requirements for pharmacists.3
Concern from Republican senators about reductions in Medicaid spending on addiction services partially accounted for the demise of the Senate’s Patient Protection and Affordable Care Act (PPACA) “repeal and replace” bill in July. In June, the Justice Department announced the largest-ever health care fraud enforcement action by arresting more than 400 doctors, nurses, and other health care professionals for false billing for opioid prescriptions.4
States have been just as active. Multiple lawsuits alleging illegal support of opioid distribution have been filed by state attorneys general. Many of those states are trying to beef up their prescription drug monitoring programs (PDMPs), which have traditionally been weak in many places, and to find ways to provide naloxone to Medicaid recipients while keeping Medicaid budgets from exploding.
Soaring rates of deaths from abuse of primarily immediate-release opioid products, such as oxycodone (OxyContin, Purdue Pharma), hydrocodone (Vicodin, AbbVie), morphine, and methadone, have captured Washington’s imagination in a way they never did during the Obama administration. And the rise of opioid addiction as a front-line political issue has far surpassed other pharmaceutical concerns—such as the bemoaned but politically ignored price of prescription drugs.
Addiction is heavily weighted toward rural areas, such as those along the Appalachians highlighted by the Cincinnati coroner. The Washington Post story highlighting Miami acknowledged: “Opioids are best known as a scourge of white, working-class America from the Midwest to New England, but the nation’s big cities, too, have been increasingly brutalized.”2 There is undoubtedly abuse in Beverly Hills and on Wall Street. But stories in the press consistently feature abusers in middle-American, rural locales such as Oklahoma, Alabama, and Ohio.
Opioids—prescription and illicit—are the main driver of drug overdose deaths. Opioids were involved in 33,091 deaths in 2015, according to the Centers for Disease Control and Prevention (CDC), and opioid overdoses have quadrupled since 1999. In 2015, the five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000). Deaths associated with the most commonly prescribed opioids rose 9.1% in the Northeast and 4.8% in the South between 2014 and 2015, while deaths blamed on synthetic opioids other than methadone, such as fentanyl, skyrocketed 107.4% in the Northeast and 95.0% in the Midwest.5The Problem in Brief
Over the past decade, prescription opioids for pain have been the issue, mostly immediate-action drugs prescribed by physicians, but sometimes longer-lasting versions, too. Excessive prescription, especially to patients who ought to have been weaned off the drugs—such as someone with acute back pain or a toothache as opposed to a cancer patient—has led to addiction to opioids, and also led many to heroin, which is cheaper and easier to obtain. State attorneys general have sued drug stores and drug distributors recently for supplying “pill mills” and other perceived crimes.
In the last couple of years, physicians have appeared to become stingier with opioid prescriptions. The CDC reported in June that the number of prescriptions for opioids such as oxycodone written by health care providers between 2012 and 2015 dropped 13.1% over the three-year period, from 81.2 per 100 people to 70.6. The Washington Post quoted Anne Schuchat, MD, the CDC’s Acting Director at the time: “It looks a little bit better, but you really have to put that in context. We’re still seeing too many people get too much for too long.” Dr. Schuchat said in the interview that the prescription rate is still triple the level it was in 1999 and four times what it is in some European countries.6
But the drugs responsible for what some call a “crisis” have begun to morph a little as deaths from overdoses of fentanyl have risen rapidly, not as a result of prescription abuse, but from nonprescription fentanyl mixed with or substituted for heroin or other illicit substances. In July, a House Energy and Commerce subcommittee held a hearing entitled “Combating the Opioid Crisis: Battles in the States” during which John Tilley, Secretary of the Justice and Public Safety Cabinet for the State of Kentucky, said the percentage of overdose deaths from drugs attributed to fentanyl rose from 34% in 2015 to 47% in 2016. Kentucky State Police reported a 6,000% increase in laboratory samples submitted to the Central Forensic Laboratory testing positive for fentanyl from 2010 to 2016. Last year, in addition to fentanyl, the Kentucky State Police reported samples from 10 different counties testing positive for carfentanil, a fentanyl analogue, which is 100 times more potent than fentanyl itself.7
According to U.S. law enforcement and drug investigators, China is the primary source of deadly fentanyl in the United States. “It appears most of the fentanyl produced in China is intended for export to our communities,” U.S. Senator Rob Portman (R-Ohio) said at a Senate hearing about U.S. strategy to combat illicit drugs. The majority of the packages arrive here via the U.S. Postal Service (USPS), which Senator Portman blames for not providing enough information, and no electronic information, to the Customs and Border Protection (CBP) agency, which is responsible for identifying suspect packages and inspecting them. The USPS and the CBP have one pilot program at one of five USPS intake centers at JFK airport in New York where the USPS is providing advanced electronic data to CBP for packages that weigh less than 4.4 pounds (known as “ePackets”). Once the USPS shares the information, CBP uses it to identify the packages it wants to inspect. The USPS then locates and presents those selected packages for inspection. “While this is a step in the right direction—after nearly 15 years of inaction—the results to date are lacking,” Senator Portman argued. “At the other four centers (JFK is the fifth), the Postal Service is stuck sifting through millions of packages trying to find a needle in a haystack. We can’t continue like this. We need more advanced electronic data, and we need it now.”8The Federal Response
The rise of fentanyl and carfentanil had not yet occurred when President Barack Obama announced his Prescription Drug Abuse Prevention Plan in 2010. That plan raised the profile of opioid abuse ever so slightly, but the Obama administration did very little of value until the end of the president’s term. The Department of Health and Human Services (HHS) waited until 2015 to unveil its Opioid Initiative. One Washington representative of an addiction advocacy group says, “We were constantly barking at them to do something.” He does credit the administration for initiating a new grant program at the HHS for medication-assisted treatment (MAT), which began in 2015 with 11 states receiving a total of $12 million. More states were added in fiscal 2016 and 2017; the 2017 pot is $26 million, and five new states will be added.9Certainly passage of the PPACA helped, too. It made substance abuse treatment one of 10 required areas of coverage for marketplace plans, and the law also expanded Medicaid coverage for able-bodied individuals under certain income limits; that coverage can be applied to substance abuse treatment.
At the very end of President Obama’s tenure in 2016, Congress passed the 21st Century Cures Act, which allocated $1 billion over two years to enhance states’ response to the epidemic. The Cures Act set up a new grant program within the HHS called the State Targeted Response (STR) to the Opioid Crisis Grants. A little less than $500 million in new money in both fiscal 2017 and fiscal 2018, over and above $53 million in opioid grants from HHS in fiscal 2016, will be distributed to all states and territories based on the degree of their opioid addiction problem. The grants will provide support to states for increasing access to treatment, reducing unmet treatment need, and reducing opioid-related overdose deaths.10
Robert Morrison, Executive Director and Director of Legislative Affairs for the National Association of State Alcohol and Drug Abuse Directors, says states have some freedom with how they use the funds, although 80% of the grants have to be devoted to treatment and recovery programs, 5% to administration, and the remaining 15% to what the state sees fit, including prevention. “The STR grants are very big and represent about a 10% increase in state addiction treatment budgets, on average,” Morrison explains. But the $500 million pales against the $10 billion Medicaid will spend on addiction programs in 2017.
It is unclear how big a dent in the untreated population those new grants will make. Mark Dunn, Director of Public Policy for the National Association of Addiction Treatment Providers, says there are an insufficient number of treatment beds for opioid addicts. Dennis Fisher, PhD, and colleagues from California State University at Long Beach, published an analysis in the February 2017 edition of the Journal of Substance Abuse Treatment that examined the discrepancy in the number of people who access substance abuse treatment and the number who need treatment, with that gap being “sizable.”11 “In our paper, we showed that the number-one reason for failing to get into treatment was no room in the drug treatment program that they applied to,” Dr. Fisher explains.
Of course, it makes sense to limit the need for treatment by limiting the availability of opioids in some situations. In June, the FDA requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER (oxymorphone hydrochloride), from the market. The agency reasoned that the benefits of the drug might no longer outweigh its risks. While Endo defended “the safety, efficacy, and favorable benefit–risk profile of Opana ER when used as intended,” it agreed to voluntarily remove it from the market.
That was the first time the FDA has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse. Then, weeks later, Commissioner Gottlieb announced that the agency intends to update the existing REMS programs on extended-release opioid analgesics, and for the first time extend these same regulatory requirements to the manufacturers of immediate-release opioid analgesic products. The emphasis will be on making sure providers understand the current thinking on the dosing of the products. In addition to training for physician prescribers, the REMS will require that training also be made available to other health care providers involved in the management of patients with pain, including nurses and pharmacists.3
Attorney General Jeff Sessions has been very active, too. In addition to the June announcement of the biggest-ever health care fraud case related to bogus opioid prescriptions, the Justice Department revealed one month later that it had reached a $35 million settlement with Mallinckrodt Pharmaceuticals to resolve allegations that the company failed to report signs that large quantities of its highly addictive oxycodone pills were diverted to the black market in Florida. The Justice Department said the deal establishes “groundbreaking” new standards that require the company to track its drugs as they flow through the supply chain to consumers in an effort to control the epidemic.12Struggles at the State Level
The fact that the new 21st Century Cures STR grants to the states require a heavy emphasis on treatment means that many states will be able to upgrade MAT programs. Terry Horton, MD, Chief of the Division of Addiction Medicine and Associate Physician Lead of the Behavioral Health Service Line at Christiana Care Health System in Wilmington, Delaware, says, “Several decades of medical research has taught us that effective opioid drug treatment requires a long-term approach with medication-assisted therapies, such as methadone and buprenorphine, counseling support, and similar means to assist with psychosocial challenges. Compared to counseling alone, participation in MAT resulted in approximately a 50% reduction in overdose fatalities.” Dr. Horton adds that Delaware’s largest substance use disorder treatment provider first began MAT when Medicaid began to cover the cost of that care. It now provides thousands of outpatient treatment slots for patients with opioid addiction—slots that he explains were at risk of being eliminated under the House and Senate PPACA repeal proposals because of the potential elimination of the PPACA’s Medicaid expansion and cuts to pre-expansion Medicaid programs.
To be able to prescribe buprenorphine, physicians must take and pass a test. Initially, they were allowed to treat only 100 patients, a cap that was increased last year to 250. Some physicians are able to join the program without taking the test via a waiver process. All three FDA-approved opioid treatment medications (methadone, buprenorphine, and naltrexone) are covered under the Medicaid Drug Rebate Program. The associated copays and authorization requirements vary from state to state. However, Morrison explains that it is one thing for a physician to be qualified to prescribe buprenorphine; it is another for them to actually do so. Many don’t for reasons having to do with insufficiency of Medicaid reimbursement or simply not wanting to treat that “particular patient” population. Other physicians won’t buy into the notion of treating drug addiction with drugs, Morrison states.
MAT programs in the states vary widely, as do PDMPs— state-run electronic databases of prescriptions for controlled substances. PDMPs can provide a prescriber or pharmacist with information regarding a patient’s prescription history, allowing prescribers to identify patients who are potentially abusing medications. With Missouri adopting a PDMP in April 2017, all 50 states, the District of Columbia, and Guam have legislation authorizing the creation and operation of a PDMP, and all but the District of Columbia program are operational. The House Energy and Commerce Committee staff, in preparation for a July 2017 hearing the committee held on state responses to opioid addiction, prepared a background memorandum that said, “While there is evidence indicating the potential of PDMPs to identify high-risk patients and impact prescribing behaviors, the effectiveness of PDMPs is constrained by the lack of consistent utilization, timely data in some states, and limited interoperability with other PDMPs.” CDC experts have found that a few states have been able to change prescribing patterns by increasing prescriber use of their PDMPs. New York and Tennessee, for example, mandated prescriber use of the state PDMP in 2012. They subsequently used their PDMPs to document declines of 75% and 36%, respectively, in their inappropriate use of multiple prescribers by patients.
The Missouri program underscores the difficulty of turning PDMPs into potent anti-abuse weapons. Missouri’s governor, Eric Greitens, signed an executive order in mid-July requiring pharmacy benefit managers to forward data on prescriptions to the state health department. Only when the second phase of the program goes into effect will pharmacies be required to report opioid prescriptions to the state. Neither physicians nor pharmacies will have access to that data, and Missouri will not be establishing a “pill shopping” database as other states have.13
The fact that many PDMPs have shortcomings may be forcing state law enforcement agencies to take more aggressive steps to blunt the crisis. A more recent strategy at the state level has been to file lawsuits against drug manufacturers, distributors, and pharmacies. This summer, the attorneys general in
Ohio, Missouri, and Oklahoma plus the district attorneys for three counties in Tennessee filed suits against the industry. The suits target some of the biggest names in the business, including McKesson, Johnson & Johnson, and CVS. Ohio Attorney General Mike DeWine charged in his suit that 10 manufacturers didn’t tell consumers the truth about their products and that their marketing claims are not supported by science and medical evidence, a violation of the Food, Drug, and Cosmetic Act. In the lawsuit, which makes arguments mirroring those in similar recent suits, Ohio says that by the late 1990s (and continuing today) “each defendant began a marketing scheme designed to persuade doctors and patients that opioids can and should be used for chronic pain, a far broader group of patients much more likely to become addicted and suffer other adverse effects from the long-term use of opioids.” Defendants in the case include Purdue Pharma, Teva Pharmaceutical Industries, Johnson & Johnson, Endo Pharmaceuticals, and others.14
The companies argue they haven’t broken any laws and are doing what they can to pitch in against the opioid abuse tsunami. Purdue Pharma, for example, is funding a National Sheriffs’ Association program that delivers naloxone overdose kits and trains front-line officers. Naloxone is a “rescue drug” that can reverse an overdose from some opioids, including heroin. “Purdue remains committed to combatting opioid abuse and equipping our communities with the tools and resources they need to do so,” said Gail Cawkwell, Chief Medical Officer of Purdue Pharma.15
While the FDA is trying to take some products off the market, it is also trying to make Narcan (Adapt Pharma, Inc.), the inhaled form of naloxone, more readily available by allowing it to be sold over the counter, which would require the product to have a drug facts label. One does not exist at the moment, and the FDA is apparently working to fill that void. Currently, the drug can only be obtained with a prescription, and the average wholesale price for a single dose is $75.16 Local police departments, sheriffs’ offices, and other personnel who are out on the street treating overdose victims say it isn’t unusual for them to administer Narcan to the same person repeatedly over a period of time. At that rate, some agencies are rationing Narcan, and even if they weren’t, one wonders how much of a solution to the crisis the drug really is.Author bio: Mr. Barlas is a freelance writer in Washington, D.C., who covers issues inside the Beltway. Send ideas for topics and your comments to sbarlas@verizon.net.
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Opioid Overdose Awareness in Southaven
Sep 5, 2017 | Desoto Times-Tribune (MS)
By Robert Lee Long
When a recovering opioid addict dies of an overdose death, the staff at Turning Point Recovery and Treatment Center in Southaven, takes it personally.
"We stick with them forever," said Stacy Dodd, Director of Operations at Addiction Campuses of Mississippi/Turning Point Recovery in Southaven.
Dodd said of the hundreds of individuals who have been treated at the Southaven campus of Turning Point, there have been nine overdose deaths of patient alumni.
"Today, we are here to honor those we have lost to overdose to bring awareness to this issue and let people know there is hope," Dodd said.
One person lost to opioid overdose is one too many, said State Sen. David Parker, R-Olive Branch, who spoke during International Overdose Awareness Day at Turning Point.
Parker was instrumental in getting the "Good Samaritan Law" passed that provides immunity from prosecution to individuals who report an overdose who may or may not have been involved with drug use themselves.
The aim is to save lives, according to Parker.
"My wife and I became aware of this overdose crisis in our area through personal connection," Parker said. "In the past, there was not a lot of awareness. In 2002, it wasn't high on anybody's radar. But when you see heroin overdoses, not just doubling, but multiplying by factors of 10, you see that it is truly a crisis."
Parker said that Gov. Phil Bryant's faith-based task force on the opioid epidemic, along with local efforts through churches like Life Fellowship Church, are among the many groups seeking to make a difference.
"What our job is — whether you are a senator, a law enforcement officer or a spouse — is to be that person that someone can lean on,' Parker said. "Having a network around you can make a difference. My prayer for you is for you to continue to look toward avenues of help and hope, and plan to fight opioid addiction."
Karen Morgan, Southeast Regional Market Director at Addiction Campuses, said that unfortunately, DeSoto County has the highest rate of overdoses in the State of Mississippi.
"We have a strong alumni base," said Morgan, adding that the many success stories of individuals who came come to Turning Point for treatment far outweigh the tragic ones, who later relapse or overdose.
She urged President Trump to make good on his pledge to make the opioid epidemic a national emergency.
Mississippi Bureau of Narcotics Director John Dowdy shared his unique perspective on the opioid epidemic from a tough prosecutor standpoint and also that of a compassionate human being.
"So far this year, there have been 125 drug overdose deaths and we are just barely through the year," Dowdy said.
While drug manufacturers, pushers and suppliers are a target in the crackdown on illegal opioids such as heroin and fentanyl, Dowdy also took aim at the pharmaceutical and medical industry.
Dowdy said there were more opioid prescriptions by doctors to individuals in Mississippi that the amount equaled one prescription for every man, woman and child in the State of Mississippi.
"Right now, opioids are the No. 1 killer for people under the age of 50," Dowdy said. "More people die from drug overdose than they do through gun violence. More people die from drug overdose than they do from car wrecks. The most important way out of this crisis is the inclusion of treatment and recovery programs as we go forward."
No one knows about the death of an opioid addict more acutely or profoundly than the parent who has lost a child to addiction.
Bobby Cooper of Southaven lost his 24-year-old daughter Jessica from opioid addiction in December of 2016.
Her lifeless body was discovered behind an abandoned house.
"My pain runs deep and hard, and it doesn't let up," Cooper said.
Sgt. Mike Cowan with the DeSoto County Sheriff's Department said law enforcement wants to put an end to drug addiction and so do those individuals who wish to come clean from a life of dependence on drugs.
"We understand that addiction is a disease," Cowan said. "We're working very hard in the community to help people understand the need to help end addiction."
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Sep 5, 2017 | Times-Tribune
By Editorial Board
A Bucks County community plans to confront the opioid epidemic by attempting to force pharmaceutical companies to provide compensation to address the crisis.
Bensalem Twp. plans to join Chicago, the state of Ohio and other communities by suing Purdue Pharma, the maker of OxyContin, and other opioid manufacturers to try to recover costs for addiction-related expenses, such as policing, and force them to change their practices.
Frustration over the growing toll of opioids in terms of lives and public expense has driven more governments to seek correction through the courts. Most heroin users started on painkillers, frequently through prescriptions from doctors.
There is no debate about the sweeping extent of the problem. Pennsylvania, for instance, had 4,642 drug overdose deaths in 2016, an increase of 37 percent from the previous year, according to the U.S. Drug Enforcement Agency.
Nevertheless, state Attorney General Josh Shapiro has resisted calls to join other states and communities in pursuit of legal remedies from the drugmakers to finance the battle against opioids. Several courts already have dismissed suits against opioid manufacturers.
Bensalem’s effort, though, fits with a trend toward government activism among municipalities and states that have been flustered by federal inaction on multiple fronts. State lawmakers nationwide, for example, have taken up hundreds of pieces of legislation over the last year to address the opioid crisis while federal assistance has stagnated.
Drug companies have powerful lobbyists and allies in Congress to protect their interests. Various efforts toward reform among states and municipalities, therefore, display an expanding bottom-up trend to offset gridlock and the power of special interests to stall measures that may benefit public health and safety.
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KRQE News 13 at 5:30pm, 9pm, 9:30pm, 10pm, 3:30am, 5:30am
Sep 1, 2017 | KRQEDT2 (FOX)
By Albuquerque, NM
Rough Transcript: "pharmecutical companies... saying they are responsible for the opioid epidemic overwhelming their community. news 13s rebeca atkins shows us how this problem is costing them money and time. mora county isn )t playing any games when it comes to fixin the problem. as you can see onhe front page of the lawsuit, the county is going after 26 diferent companies and doctors at make and distribute the drugs. 6:12 "it hit our family so fast that i never saw it coming." 6:15 fo jennifer weis-burke, opioid addiction hits close to home. 0:31 "my son camero pased away of a opioid overdose about 6 years ago." 0:3 her son, an athlete, was prescribed opiods for a sports related injury. his addiction lost hm his life. she )s now the executive director of healing addiction in our comunity. 1:27 "opioids are a problem all over the united states, and new mexico is no different." 1:29 such a problem... there )s a new push... states, counties even cities are taking legal action. 7:34 "mora ha couragiously decided to lead here in new mexico and has chosen to be the first county to file a lawsuit against the drug manufacturers as wel as specific doctors." 7:45 5:32 AMjoshua conaway is representing the county of mora. 7:55 "here in new mexico, mora is among the worst counties as far as per capita, when it comes to the opioid epidemic." 8:0 alleging the companies and doctors are to blame. 9:22 "they have engaged in a marketing campaign that has basicaly marketed to doctors by overstating the effectiveness of this drug, while at thesame time minimizing the problems that are associated with the drugs." 9:3 the county is seeking damages for the cost of extra law enforcement, lost productity, and health costs asociated with the opioid problem. and people like weiss-burke back the vement. 3:10 "i aplaud them fo taking a step in this direction and maybe it will make a diference." 3:14 among the doctors listed in the lawsuit, is one who plead guilty last year to ilegaly dispensing prescription pain killers. rebecca atkins krqe news 13. the atorney handling the lasuit says he expects other new mexico counties to file suit as well."
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