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Opioid Litigation Daily Media Report - 11/13/17

Litigation Coverage

Wisconsin lawsuit blames drug makers for opioid crisis
Nov 12, 2017 | Goozer Nation (WI)
By Melvine Watkins

Almost 24 Wisconsin counties are suing manufacturers of painkillers, claiming in a lawsuit on Tuesday that the firms’ nefarious and misleading promotional campaigns triggered the country’s opioid overdose crisis.
Kentucky City Sues Drug Companies for Opioid Addiction Costs
Nov 10, 2017 | AP
By Staff

A Kentucky city is suing more than a dozen drug manufacturers and distributors to recoup the escalating cost of dealing with drug addiction.
Tompkins County joins opioid lawsuit, adopts 2018 budget Thursday
Nov 10, 2017 | Ithaca Journal (NY)
By Sarah Mearhoff

Tompkins County joined the ranks of Broome, Seneca and seven other New York state counties Thursday night in pursuing a lawsuit against opioid manufacturers who have “harmed the County by promoting the abuse of opioids.”
Fort Payne files suit against opioid pharmaceutical companies
Nov 10, 2017 | WAFF (AL)
By Stephen McLamb

The city of Fort Payne is filing suit against several major pharmaceutical companies.
Harrison County joins opioid lawsuit
Nov 10, 2017 | Longview News Journal (TX)
By Robin Y. Rhichardson

Harrison County this week became the newest county to join a lawsuit that targets pharmaceutical companies and their role in the nationwide opioid epidemic.
Opioid epidemic leads Liberty County to sue drug manufacturers
Nov 10, 2017 | NewsFix (TX)
By Mike H

The opioid epidemic is sweeping across America and has started to hit close to home.
Pharmaceutical companies sued for alleged role in opioid epidemic
Nov 10, 2017 | WFMZ (PA)
By Staff

Luzerne County has slapped lawsuits against more than a dozen pharmaceutical companies for their alleged role in the opioid epidemic.
Santa Fe County considers suing opioid makers
Nov 10, 2017 | Albuquerque Journal (NM)
By T.S. Last

Santa Fe County could join other local and state governments in taking legal action against the manufacturers and distributors of drugs that have contributed to the country’s opiate epidemic.
County commissioners consider opioid lawsuit
Nov 12, 2017 | Forsyth County News (NC)
By Kelly Whitmire

Forsyth County may join other counties and cities in taking action against manufacturers of opioids and those who have profited from their sale.
Mayor plans possible opioid lawsuit
Nov 10, 2017 | Nashville Post (TN)
By Stephen Elliott

Mayor Megan Barry’s office intends to hire law firm Lieff Cabraser Heimann & Bernstein to investigate and possibly sue opioid manufacturers and distributors “that have wrongfully caused drug addiction in Davidson County and resulting economic harm to the Metropolitan Government,” according to legislation filed with the Metro Council Friday.

Commentary and FYIs

MDL panel will hear opioid consolidation arguments Nov. 30 in St. Louis
Nov 10, 2017 | The Madison County Record (WI)
By Staff

Judges on a national panel must decide whether to consolidate opioid suits of local governments and if so, whether to send them to West Virginia, Illinois or Ohio.
The Opioid Files: More Than 100 States and Cities Are Suing Drug Companies
Nov 13, 2017 | Governing
By Mattie Quinn

A few years ago, Mississippi Attorney General Jim Hood was worried about a friend’s son who served two tours in Iraq. After being injured overseas, he became dependent on prescription painkillers and eventually developed a heroin addiction.
Federal prosecutors take on pharmaceutical companies for their alleged role in opioid crisis
Nov 11, 2017 | Fox News
By Molly Line

The billionaire founder of a pharmaceutical company is the latest to face criminal charges as prosecutors seek to hold big business drug makers responsible for the role they have played in the opioid crisis.
The Deadly Game Big Pharma Played on the American People
Nov 12, 2017 | The Doctor Weighs IN
By Leah White

The problem of opioid abuse in this country has been growing for the past few decades, with the number of opioid-related deaths sharply increasing in the last four years. From 2014 to 2015, deaths caused by heroin overdose increased by 23% and synthetic opioids, other than methadone, increased by 73%. Some states are more affected than others. In Ohio, for example, there were 1,800 opioid-induced deaths just in the last year. This is more than any other state has ever seen before.
Q&A: Attorney Judy Scolnick Confronts Opioid Epidemic
Nov 10, 2017 | Connecticut Law Tribune
By Robert Storace

With Connecticut and the nation’s opioid epidemic continuing to kill people by the thousands, resulting lawsuits are also on the rise. Within the past year, at least 25 states, cities and counties have filed civil cases against manufacturers, distributors and pharmacy chains that have played a part in the $13 billion-a-year opioid industry.
Court: Travelers Off the Hook for Opioid Maker's Defense
Nov 12, 2017 | Connecticut Law Tribune
By Michael Marciano

Travelers Property Casualty Co. of America doesn’t have to pay to defend an opioid maker that was sued by two California counties and the city of Chicago.
Court rules Travelers does not have to pay for opioid maker’s defense
Nov 13, 2017 | Insurance Business Journal
By Lyle Adriano

California’s Court of Appeal, Fourth Appellate District, Division Three ruled last week that Travelers Property Casualty does not have a duty to defend or indemnify Watson Pharmaceuticals.
Shelby County Mayor Not Happy Camper Over Opioid Lawsuits
Nov 13, 2017 | Local Memphis (TN)
By Mike Matthews

Shelby County Mayor Mark Luttrell isn't saying whether he will veto the vote from commissioners, but clearly he is not a happy camper. "We've got to look at it legally and see what we can do to make it move forward," he says.
DEA Cutting Rx Opioid Supply in 2018
Nov 10, 2017 | Pain News Network
By Pat Anson

The U.S. Drug Enforcement Administration is going ahead with plans to reduce the supply of many opioid painkillers by 20 percent next year. That’s in addition to steep cuts in opioid production quotas the agency imposed in 2017.
The Insanity of Taxpayer-Funded Addiction (EDITORIAL)
Nov 10, 2017 | The New York Times
By Editorial Board

The pharmaceutical industry was listed as one of the “Contributors to the Current Crisis” in the final report of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. The report cites decades of aggressive marketing and industry-sponsored physician “conferences” aimed at expanding opioid use by minimizing the dangers of addiction. Lawsuits by state attorneys general, counties and local jurisdictions allege that the industry fostered the epidemic by overpromoting its products, while raking in billions as Americans became addicted and overdosed. “To this day,” the commission says, “the opioid pharmaceutical industry influences the nation’s response to the crisis.”
Medical professionals need to play a role in opioid crisis (EDITORIAL)
Nov 13, 2017 | The Salt Lake Tribune
By Leah Hogsten

First do no harm.
Texas' Big Pharma troubles (EDITORIAL)
Nov 13, 2017 | Benefits Pro
By Dan Cook

Perhaps it’s time for America’s drug company executives to schedule a long conference call with America’s tobacco company executives to have a little chat about liability.
State Leaves Counties to Sue Drug Companies (EDITORIAL)
Nov 11, 2017 | Urban Milwaukee (WI)
By State Senators Janet Bewley and Dave Hansen

County after county across Wisconsin is facing budget-busting costs related to the state’s opioid crisis. Jails are full and treatment centers, where they exist, are often filled beyond capacity. Time and time again we have heard from county officials that they need more from a state government that has too often left them to face this crisis on their own.
Is There A Way To Keep Using Opioid Painkillers And Reduce Risk?
Nov 13, 2017 | WNYC (NY)
By Allison Aubrey

AUDIO (3 Min): http://www.wnyc.org/story/is-there-a-way-to-keep-using-opiod-painkillers-and-reduce-risk/ Jon McHann, 56, got started on prescription opioids the way a lot of adults in the U.S. did: he was in pain following an accident. In his case, it was a fall.
Brain Scientists Look Beyond Opioids To Conquer Pain
Nov 13, 2017 | WNYC (NY)
By Jon Hamilton

The goal is simple: a drug that can relieve chronic pain without causing addiction.

Broadcast Media Coverage

2 News at 5:30am
Nov 13, 2017 | KUTV (CBS)
By Salt Lake City, UT

Video Link: http://app.criticalmention.com/app/#clip/view/30649960?token=ac5e6192-da7d-44cf-a139-918fa1f68c5f
Good Morning Acadiana
Nov 13, 2017 | KATC (CBS)
By Lafayette, LA

Video Link: http://app.criticalmention.com/app/#clip/view/30649996?token=ac5e6192-da7d-44cf-a139-918fa1f68c5f

Litigation Coverage

Wisconsin lawsuit blames drug makers for opioid crisis

Nov 12, 2017 | Goozer Nation (WI)

By Melvine Watkins

Almost 24 Wisconsin counties are suing manufacturers of painkillers, claiming in a lawsuit on Tuesday that the firms’ nefarious and misleading promotional campaigns triggered the country’s opioid overdose crisis.
The claim seeks unidentified redress and says the district health and law enforcement services have been stressed to the limit because of the opioid epidemic that has led to the death of many. More than 24 states, cities, and districts have taken legal actions against drugs companies, with the accusation of concealing the dangers of their drugs just to make more profits.
Door, Florence, Fond du Lac, Oconto, Shawano, and Waupaca are the Northeast Wisconsin counties joining the lawsuit.
The companies’ objective was straightforward: to generate more profit by convincing doctors and medical specialists that their products were safe and effective for treating severe short-term pain associated with surgery or cancer and other minor long-term pains, for example, back pain and arthritis.” says the lawsuit filed in the Eastern Counties of Wisconsin.
The defendants were aware that their “drugs were addictive, unsafe or ineffective for long-term use.” the claim says. It listed Purdue Pharma, Endo Health Situations, Johnson & Johnson, and subsidiaries of the companies. The names of three medical doctors in California and Utah are also on the list.Drug makers deny allegations
“We absolutely deny these charges and look forward to presenting our defense.” Purdue Pharma argued in a statement that also said the company is lugubrious because of the opioid epidemic and we’re committed to finding a solution to the crisis.”
Endo Health Solutions announced that its “aims include patient well-being and ensuring that patients with severe pain have access to safe and efficacious remedial options” while preventing any form of abuse. The company said it wasn’t ready to give further comments. Johnson & Johnson said it is yet to receive a complaint from the counties, but the accusations in similar claims are “lawfully and genuinely unwarranted.”
In 2015, over 52,000 Americans died from overdoses, most of them involving cases of opioid or related hard drugs like heroin and fentanyl, according to the US Centers for Disease Control and Prevention.
According to the lawsuit, opioid overdoses have claimed 1,824 lives in Wisconsin from 2013 to 2015. Washington County recorded 542 hospitalized cases and 70 deaths from 2013 to 2016.

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Kentucky City Sues Drug Companies for Opioid Addiction Costs

Nov 10, 2017 | AP

By Staff

A Kentucky city is suing more than a dozen drug manufacturers and distributors to recoup the escalating cost of dealing with drug addiction.
The Lexington Herald-Leader reports the city of Lexington filed a federal lawsuit on Thursday, alleging the companies helped cause an opioid addiction epidemic by flooding the city with pain pills.
Councilman Richard Moloney, who encouraged the merged city-county government to join more than 30 other counties in suing drug wholesalers, says they're focusing on recovering the costs to the city and aren't joining the state's lawsuit, which is going after fines.
The city's total costs haven't been tallied, but it spends more than $1 million a year on drug treatment.
The senior vice president of the Healthcare Distribution Alliance, John Parker, called the lawsuits misguided in September.

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Tompkins County joins opioid lawsuit, adopts 2018 budget Thursday

Nov 10, 2017 | Ithaca Journal (NY)

By Sarah Mearhoff

Tompkins County joined the ranks of Broome, Seneca and seven other New York state counties Thursday night in pursuing a lawsuit against opioid manufacturers who have “harmed the County by promoting the abuse of opioids.”
Passed by the legislature in a 12-2 vote (legislators Shawna Black and Dooley Kiefer dissenting), the county legislature authorized County Attorney Jonathan Wood to begin civil litigation against opioid manufacturers, according to a news release by the county.
Tompkins will be joining Erie, Dutchess, Nassau, Orange, Seneca, Schenectady, Sullivan, Suffolk and Broome Counties – bringing the total up to ten counties.
Spearheaded by Suffolk County, the suit claims that pharmaceutical companies consciously misrepresented or downplayed the addictive qualities of opioids and painkillers. The counties argue these actions sprinkled gasoline on the nation’s forest fire of an opioid epidemic, thus costing county government millions in emergency services and healthcare costs.
“We are spending a significant amount of money to address the problems caused by these opioid manufacturers,” District 4 Legislator Rich John said in support of the legal pursuit. “It’s important that this crisis not be hidden. Bringing a lawsuit may bring some attention to that, and sends a clear message that Tompkins County joins other counties in saying this is not acceptable.”
The legislature also adopted the county’s 2018 budget Thursday by a unanimous vote.
The county’s $180 million budget increased the County tax levy by 2.32 percent – staying under the state’s tax cap of 3.53 percent.
While the tax levy rose, the tax rate dropped by less than 1 percent, coming in at $6.58 per thousand, 4 cents less than in 2017. Owners of median-valued homes ($178,000) in the county can expect an increase of $11.42 on their 2018 tax bills.
Meanwhile, local spending will rise 2.87 percent in 2018.
The legislature has been mulling over the budget since September, holding regular meetings to consider every detail of every department’s allowances.
“I remain pleased with the way this process works,” County Administrator Joe Mareane said. “In the end, the result is worth it.”

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Fort Payne files suit against opioid pharmaceutical companies

Nov 10, 2017 | WAFF (AL)

By Stephen McLamb

The city of Fort Payne is filing suit against several major pharmaceutical companies.
The lawsuit stems from the public abuse of opioids.

Mayor Larry Chesser says the ultimate goal is for this to become a class action lawsuit.

The city council voted to join the suit filed on their behalf by a Birmingham law firm on the advice of their attorney.

Mayor Larry Chesser says they got a request to join other cities and states who are filing suit against pharmaceutical companies who make opioids.

Chesser says in the past there were problems with crack cocaine and methamphetamine but the illegal use of prescription pain pills is a bigger problem.

The mayor feels anything to help fight the drug problem is a good thing.

"A lot of it in my opinion is due to advertising and over supply from the pharmaceutical companies pushing it, for doctors don't take, in my opinion, the precautions that they should," said Mayor Chesser.

Mayor Chesser says filing the suit comes at no cost to the city.

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Harrison County joins opioid lawsuit

Nov 10, 2017 | Longview News Journal (TX)

By Robin Y. Rhichardson

Harrison County this week became the newest county to join a lawsuit that targets pharmaceutical companies and their role in the nationwide opioid epidemic.
"Every state, every county — unfortunately your county, Harrison County — is not immune to the problem of the opioid crisis," said Boyd Smith, an attorney with Gallagher Law Firm in Houston. Harrison County Commissioners voted to retain the law firm to represent the county in litigation.
Other counties that are part of the litigation include Upshur, Rusk, Smith and Marion counties.
Opioids are a family of drugs that includes prescription painkillers such as hydrocodone, illegal drugs such as heroin and synthetic opioids such as fentanyl. The addiction to the drugs is an epidemic that has been sweeping the nation, health officials say.
Smith said drug companies and manufacturers that will be listed as defendants in the lawsuit created the problem through deceitful and illegal activity. And because the issue is not only costing lives but also costing counties, Smith said, law firms are visiting with counties regarding what can be done — at no cost to the county — to try to stop the conduct and recoup some money for taxpayers.
The attorney noted that deaths from opioid abuse in this country have quadrupled since 1999. About 78 people in the U.S. die a day from opioid overdose, the U.S. surgeon general said in a report published in November 2016. About 1,186 Texans died in 2015 of opioid abuse, Smith said.
"It's right here in Harrison County," he said. "And it's not just grownups. It's kids, unfortunately. It's in our schools. ... Four percent of your population here reported on themselves using these drugs for nonmedical purposes last year. This is terrible."
According to the Centers for Disease Control, for every hundred residents in Harrison County last year, there were 72 prescriptions reported for opioids.
To stop the problem, Smith said, drug companies need to be hit in the pockets — "the only place they pay attention to."
"How do we do that and how does it cost the county no money to try to do that is by filing a lawsuit on behalf of Harrison County against these manufacturers and others," he said. "If we win, then yes we get 35 percent of recovery; but if we lose, the county pays nothing — not one penny of the taxpayers goes to fees."
He said the law firm is filing the case on the theory that these drugs are a public nuisance.
"As I think we all recognize, there are valid uses for these morphine-like drugs," Smith said. "What we need to do is re-empower our physicians. Give them accurate information. I used to represent hospitals and clinics in Houston in health care litigation.
"I know for a fact those doctors rely on the truthfulness, the accuracy of the information they get from these drug companies. And when they start committing fraud and misleading our doctors, they need to be stopped."
The estimated amount that may be recovered from the litigation filed by Harrison County exceeds $100,000, according to the contract.

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Opioid epidemic leads Liberty County to sue drug manufacturers

Nov 10, 2017 | NewsFix (TX)

By Mike H

The opioid epidemic is sweeping across America and has started to hit close to home.
"I dare say there isn't a family who hasn't been touched in some sort of way by the opioid epidemic," Liberty County Attorney Matthew Poston suggested.
The crisis has gotten so out of control that Liberty County is now mounting a lawsuit against drug manufacturers.
"These manufacturers and distributors have been selling these drugs as if they're safe products," Poston pointed out. "And even when used as they're directing, they're not safe. They're actually very dangerous."
And authorities say Big Pharma is profiting from addiction!
It's a growing problem, commonly started with a simple prescription for pain relievers.
"If you look at the number of folks who are addicted a year out after they've been given a short, 10-day prescription the numbers are astronomical, unacceptable!" Poston said.
Beyond the personal costs involved, officials say the county government faces plenty of costs from addiction, too. "Costs to arrest these individuals, costs to incarcerate them, a number of costs to treat them while they're in custody," Poston said.
And county officials say they are feeling that especially hard here.
"Here in Liberty County, we have recognized that not only are there private costs to these individuals, but there are social costs that are being borne by our government, and we seek to be compensated," Poston insisted.
Officials won't say just how much they are seeking, but they hope to use any funds they might be awarded to beef up local services to help residents who are suffering and help stop the addiction.
As Poston put it, "We would hope that the flagrant, dangerous practice of selling very risky products will stop."
Amen to that!

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Pharmaceutical companies sued for alleged role in opioid epidemic

Nov 10, 2017 | WFMZ (PA)

By Staff

Luzerne County has slapped lawsuits against more than a dozen pharmaceutical companies for their alleged role in the opioid epidemic.
The suit alleges that they aggressively persuaded doctors to prescribe highly addictive opioids to patients for profit.
Those patients claim they turned into addicts.
Luzerne's opioid deaths climbed from 67 in 2013 to 140 in 2016 which is above the statewide average.
The suit says costs for damages should include expenses incurred for medical care, rehabilitation, law enforcement and public safety.

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Santa Fe County considers suing opioid makers

Nov 10, 2017 | Albuquerque Journal (NM)

By T.S. Last

Santa Fe County could join other local and state governments in taking legal action against the manufacturers and distributors of drugs that have contributed to the country’s opiate epidemic.
County Commissioner Anna Hansen is introducing a resolution that calls for the county to hire someone to represent it in litigation against “opiate manufacturers, distributors and other relevant parties,” possibly in collaboration with other government entities.
The resolution is on the agenda for next Tuesday’s County Commission meeting.
“Our county and our residents are suffering from the effects of all these opioids that have overpopulated our county and state,” Hansen said in a phone interview. “And it’s unfair to ask residents to pay for what these manufacturers of pharmaceuticals are doing to our community. They should be held responsible.”
More than 40 states, including New Mexico, have already filed lawsuits against pharmaceutical companies or distributors they allege are responsible for the opioid epidemic.
New Mexico’s Mora County became the first county in the state to take legal action when in August it sued numerous major pharmaceutical manufacturers, accusing them of knowingly overdistributing addictive drugs. A few weeks later, New Mexico Attorney General Hector Balderas filed a lawsuit against five major manufacturers and three distributors.
The Santa Fe County resolution notes that President Donald Trump last month declared a public health emergency due to opioids and that more than 183,000 Americans died from overdoses of prescription opioids from 1999 to 2015.
It states that state Health Department statistics show that 178 people in Santa Fe County died from drug overdoses from 2012 to 2015 and that nearly three times as many people (68) died from drug overdoses in the county in 2016 than were killed in automobile accidents (23).
Due to the opioid epidemic, Santa Fe County has incurred “substantial costs” related to drug overdoses, including medical treatment, transportation, incarceration and connecting inmates with appropriate services to treat people suffering from addiction, the resolution says.

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County commissioners consider opioid lawsuit

Nov 12, 2017 | Forsyth County News (NC)

By Kelly Whitmire

Forsyth County may join other counties and cities in taking action against manufacturers of opioids and those who have profited from their sale.
This week, Forsyth County Commissioners heard a presentation from District 91 state Rep. Vernon Jones, of Lithonia, and Shayna Sacks, an attorney with Napoli Shkolnik PLLC, about filing a lawsuit, though commissioners did not take action at the meeting.
The lawsuit will not be a class action but a local suit in Forsyth County courts and will be filled on contingency.
“The opioid epidemic, as you know, it has no boundaries, no jurisdiction, no gender, no race, no age, no anything,” Jones said. “It’s literally killing people.”
Jones said about 46 state attorneys general were preparing for similar litigation, though local cases will have more control.
“Like the tobacco litigation … the AGs determined where the funding would go, who would get the funding, who would not get the funding,” Jones said. “Cases are being formed on behalf of local gov-ernments themselves so when there is an award, the local government will receive that award and you can determine how you prefer that money to be spent.”
He said municipalities need to file suits ahead of the state to control the funding.
In recent years, opioids and their effects have been a growing issue both nationally and locally, and in October, President Donald Trump declared the crisis a public health emergency.
Sacks gave commissioners a brief rundown of how the drugs affect users.
“The drugs interact with the receptors in the brain; what happens is they attach to the receptors,” she said. “They’re primarily used for pain relief, including anesthesia. These drugs were originally designed for people who were on death’s door.”
Sacks said in 2015, 300 million prescriptions were written for the drugs, “enough for each American adult to get their own bottle of pills,” and Georgia’s numbers were increasing.
She said the nationwide cost of the epidemic is $55.7 billion in lost productivity through businesses, healthcare costs and criminal justice.
“Basically, the stem of the lawsuit has to do with negligence,” Sacks said. “The pharmaceutical companies, manufacturers and the distributors have a duty to pay attention to what they’re doing; they can’t just sell medication — medication as strong as this — and not have any consequences.”
Commissioners did not take action, but County Attorney Ken Jarrard plans to review the agreement.

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Mayor plans possible opioid lawsuit

Nov 10, 2017 | Nashville Post (TN)

By Stephen Elliott

Mayor Megan Barry’s office intends to hire law firm Lieff Cabraser Heimann & Bernstein to investigate and possibly sue opioid manufacturers and distributors “that have wrongfully caused drug addiction in Davidson County and resulting economic harm to the Metropolitan Government,” according to legislation filed with the Metro Council Friday.
Metro Government issued a request for qualifications this summer seeking a law firm to serve as special counsel to explore possible litigation against opioid companies, with responses due Sept. 1.
“Every day, the opioid epidemic costs our community in lives lost, families destroyed and financial burdens on city services," Barry said through a spokesperson Friday. "Outside counsel has been requested in order to determine what role prescription drug companies have played in causing this epidemic. While financial awards do not bring back the lives of those lost, they can hold companies accountable and result in positive change when federal or state regulations fall short.”
The firm has experience in similar large-scale litigation. Attorneys from Lieff Cabraser’s Nashville office have in recent years secured multi-million-dollar judgments against tobacco companies charged with wrongful death.
Due to a Metro holiday Friday, a list of other law firms that submitted proposals could not be obtained by press time. Barry spokesperson Sean Braisted said five firms responded to the request. Representatives for Lieff Cabraser also could not be reached for comment.
“Special Counsel will first determine if evidence actually exists documenting the economic impact that prescription opioids have had on the Metropolitan Government and its residents,” the RFQ states. “Special Counsel will inform the [Metro Legal] Director which manufacturers and distributors of prescription opioids have caused significant harm in Davidson County and whether any of the manufacturers or distributors have already settled lawsuits alleging such misconduct or have already been found in a judicial proceeding to have engaged in such misconduct.”
The law firm would be responsible for determining if Metro is part of an already existing class of plaintiffs. The Shelby County (Memphis) Commission last week announced it had engaged the law firm Napoli Shkolnick to pursue litigation against drug manufacturers and others (though County Mayor Mark Luttrell has disputed its authority to do so). Attorneys for Nashville-based Branstetter, Stranch and Jennings this summer filed suitagainst drug manufacturers on behalf of three East Tennessee district attorneys general.
Legal fees and compensation for the special counsel would come from damages secured as part of the litigation, according to a draft contract included with the RFQ.
The draft contract stipulates that Lieff Cabraser would be responsible for investigating “whether the Metropolitan Government should pursue litigation against manufacturers and distributors of prescription opioids that have wrongfully caused opioid addiction in Davidson County, Tennessee, and in turn, caused the Metropolitan Government to expend scarce resources combating its effects. The economic impact of opioid addiction may include, but not be limited to, the cost of drug addiction treatment, emergency room visits, law enforcement response, incarceration, child abuse and neglect and the cost of removing children from parental custody, as well as medical treatment for prenatal opioid exposure.”
Lieff Cabraser would represent Metro through trial, appeals and until damages are recovered, according to the RFQ.

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Commentary and FYIs

MDL panel will hear opioid consolidation arguments Nov. 30 in St. Louis

Nov 10, 2017 | The Madison County Record (WI)

By Staff

Judges on a national panel must decide whether to consolidate opioid suits of local governments and if so, whether to send them to West Virginia, Illinois or Ohio.
Defendants agree that if consolidation happens, District Judge David Faber of Charleston, West Virginia, should preside.
Some West Virginia governments recommend Chief District Judge Edmund Sargus in Cincinnati, while others oppose consolidation.
St. Clair County recommends District Judge Staci Yandle in Benton.
Faber, with 17 actions in his court, has held hearings and issued rulings.
Yandle presided over a single action until Oct. 30, when Chief Judge Michael Reagan of East St. Louis assigned four new ones to her.
Decisions rest with the U.S. Judicial Panel on Multi District Litigation, which will hear argument in St. Louis on Nov. 30.
James Peterson of Charleston moved for consolidation on Sept. 25, on behalf of counties in Kentucky, Ohio, West Virginia and Illinois.
In West Virginia, he represents Kanawha, Fayette, Boone, Logan, Cabell, and Wayne counties.
Peterson also represents the cities of Cincinnati, Louisville, and Birmingham.
He asked the panel to transfer pending and subsequent actions to Sargus, and he offered Yandle as an alternative.
Theories being advanced in the litigation include public nuisance, negligence, Racketeer Influenced and Corrupt Organizations (RICO), and/or state corrupt or trade practices laws.
Among the many common questions plaintiffs outline in the brief are defendants' legal duty to design and operate a "closed system" to prevent drugs from going into illegitimate channels; whether defendants breached duty to design and operate a closed system; whether defendants breached duty to stop suspicious orders into illicit channels; whether and the degree to which defendants promoted the drugs for off-label purposes; and "whether the flood of dangerous prescription opioid drugs into illicit channels caused, and the degree to which such diversion caused, individuals to suffer crippling addiction and to then turn to heroin."
The first reaction came not from defendants but from a prominent plaintiff, West Virginia attorney general Patrick Morrissey.
On Oct. 16, Morrissey deputy Vaughn Sizemore wrote that the consolidation motion improperly included the state’s case.
“Of the cases identified in the motion to transfer, only the case at bar was brought by a state,” Sizemore wrote.
He wrote that the state predicated its claims exclusively on West Virginia law alleging violation of its controlled substances act and its consumer credit protection act.
He wrote that the only reason the case was included in the motion was because McKesson improvidently removed it and that Faber would likely remand it to Boone County circuit court.
Faber had not reached a decision as of Nov. 9.
Sizemore wrote that if the panel consolidates the state’s case with others, the panel should assign the litigation to Faber.
A division on the plaintiff side appeared on Oct. 20, when eight West Virginia local governments opposed consolidation.
Their lawyers wrote that transfer would decrease efficiency and convenience.
They wrote that their clients wholly eschewed citation to federal law and their cases depend on the rather unique oversight structure under West Virginia law and the attendant regulations of its pharmacy board.
They wrote that they intend to show that specific orders shipped to specific locations were suspicious on their face and distributors were aware of it.
“This is a uniquely and necessarily individualized inquiry,” they wrote.
They wrote that establishing damages would require review of individual municipal budgets, expenses, and costs.
Another plaintiff stepped away from Peterson on the same date, when St. Clair County recommended Yandle as first choice.
County counsel Christopher Cueto wrote, “Judge Yandle is not currently presiding over a multi district litigation and is eminently qualified in complex litigation to prudently and efficiently steer this litigation.”
The big three distributors - McKesson, AmerisourceBergen, and Cardinal Health, Inc. - didn’t resist consolidation.
The three jointly supported it on Oct. 20, and requested assignment of Faber.
“Judge Faber is already deeply invested in this litigation,” they wrote.
They wrote that lawyers who filed 47 of the 66 cases subject to the motion filed their first seven cases in the Southern District of West Virginia.
“No other federal case, including those in the Southern Districts of Ohio and Illinois, has advanced beyond filing complaints,” they wrote.
They wrote that Yandle’s court isn’t convenient for any of the parties.
On the same date, retailers opposed consolidation.
For Walgreen and Kroger, Ronda Harvey of Charleston wrote that counties and municipalities in nine states with different statutes and rules brought the actions.
Harvey wrote that the suits don’t implicate retail pharmacies of Walgreen and Kroger, but focus on them as wholesale distributors.
She wrote that Walgreen and Kroger distributed products from their own warehouses on their own trucks to their own stores.
For Rite-Aid, Webster Arcenaux of Charleston wrote that consolidation would increase inconvenience and expense while delaying resolution.
Arcenaux wrote that it would impose additional costs on litigants and witnesses; that superficial factual disparities at a distance disappeared up close and that key questions were profoundly space specific.
He further wrote that Faber’s chief judge, Joseph Goodwin, coordinated the actions rather than consolidate them into a single action.
He wrote that centralization could benefit Rite-Aid only if the panel centralized the cases in West Virginia.
For CVS, Richard Schirtzer of Los Angeles asked the panel to deny consolidation, carve out the West Virginia actions, or consolidate only claims against the big three.
“It would be manifestly unfair to subject the CVS defendants to the dramatically increased burden and costs associated with multi district litigation when CVS has been named in only the four West Virginia cases,” Schirtzer wrote.
For Wal-Mart, Neva Lusk of Charleston wrote that transfer to a multi district court would only create inefficiency and unfairness.
She wrote that differences among cases far outweighed common issues of fact.
“Some of the 66 cases assert claims against wholesale distributors only, others assert claims against pharmaceutical manufacturers only, while others assert claims against some combination of distributors, manufacturers, or providers,” she wrote.
“Depending on the identity of the named defendants, the complaints in these cases proceed under different legal theories.”
On Nov. 9, Cueto withdrew as counsel for St. Clair County and former Madison County chief judge Ann Callis replaced him.

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The Opioid Files: More Than 100 States and Cities Are Suing Drug Companies

Nov 13, 2017 | Governing

By Mattie Quinn

A few years ago, Mississippi Attorney General Jim Hood was worried about a friend’s son who served two tours in Iraq. After being injured overseas, he became dependent on prescription painkillers and eventually developed a heroin addiction.
But then, his friend's son got into law school and showed signs of sobriety, so Hood offered him an internship in his office. A few days into the internship, he didn’t show up.
“We called his wife, and she went home to check up on him," Hood says. "He was dead of an overdose."
Shortly after that, in 2015, Hood became the first state attorney general to sue a prescription drugmaker for their role in the opioid epidemic. Since then, more than 100 states, cities and counties have filed similar lawsuits, with a new one popping up almost every week.
Drug dependency isn't a new problem, but unlike most drug epidemics, the opioid one is largely driven by a legal industry. The National Institute on Drug Abuse estimates that 75 percent of people who enter treatment for a heroin addiction took their first opioid legally from a prescription.
States have tried to crack down on the problem, primarily with prescription drug monitoring databases that track what patients have been prescribed by doctors within and across states. But if addicts can't get prescription painkillers, they typically resort to illegal drugs, including heroin, fentanyl and carfentanil. The latter two are at least 50 times stronger than heroin and can kill users within seconds.
The Centers for Disease Control and Prevention estimates that each day, 91Americans die from overdosing on opioids. And it's not just a human tragedy -- the opioid epidemic has a financial cost, too.
“It’s devastated county and municipal budgets. There’s been a significant cost for law enforcement, first responders, for drug treatment, for lost productivity of government workers and for services like autopsies,” says Mark Chalos, a Nashville-based partner at Lieff Cabraser Heimann & Bernstein, LLP a law firm counseling some of the counties in Tennessee exploring lawsuits.
Some places in Tennessee, he says, can no longer afford to do autopsies for every suspected drug overdose, so it’s likely that the official count of deaths from the opioid epidemic “is just the floor."
In addition to the 100-plus lawsuits, 41 states have banded together to subpoena information from four drug manufacturers: Endo, Johnson & Johnson's Janssen unit, Teva Pharmaceutical and Allergan. They’ve also put in a request for more information to Purdue Pharma and drug distributors AmerisourceBergen, Cardinal Health and McKesson.
“If we get into those emails and executives are in the chain knowing what they’ve unleashed on the American public, I’m going to kick it over to a criminal lawsuit," says Hood. "I’ve been to too many funerals."
For now, all of the cases are civil. Most localities are seeking monetary damages to help them recoup the money lost to fighting the epidemic. Many of the lawsuits also hope to force drugmakers to change their marketing tactics, which they argue are deceptive, to make it more clear just how addictive the pills can be.Tobacco Déjà Vu?
These cases have drawn comparisons to the lawsuits in the late 1990s against tobacco companies. As it happens, Mississippi led the way on that too. After Mike Moore, the state's then-attorney general, took tobacco to court, 40 states followed.
"The lawsuit is premised on a simple notion," Moore said at the time. "You caused the health crisis; you pay for it."
It worked: The tobacco industry was court-ordered to pay more than $200 billion to states over 25 years. That cash is still rolling in and will be until 2025. Those lawsuits also resulted in significant policy changes, including a ban on most forms of outdoor advertising, including billboards and transit ads. Tobacco companies are also now banned from marketing to teenagers and were required to fund an anti-smoking advocacy group, which airs the Truth ad campaigns.
It's too soon to say exactly how similarly the opioid cases will play out. But Chalos, the lawyer, says he's "optimistic that the industry will be held accountable in the end." He warns, however, that drugmakers have big resources and are expected to fight tooth and nail.
For their part, the drugmakers say they have taken steps to curb addiction and help states fight overdoses. In a statement to NBC News, Purdue Pharma said: "We are an industry leader in the development of abuse-deterrent technology, advocating for the use of prescription drug monitoring programs and supporting access to Naloxone -- all important components for combating the opioid crisis."
But most of the governments argue in their cases that drug companies violated consumer protection statutes by deceiving the medical community about the likelihood of addiction and inadvertently putting patients in danger. Many lawsuits are also claiming that drug companies committed Medicaid fraud by forcing taxpayers to pay for unnecessary prescriptions.
If a judge rules that drug companies violated consumer protection statutes, Hood says states could receive up to $10,000 per occurrence, which a judge could interpret as each prescription or each doctors visit. Either way, that would result in trillions of dollars for the state and local governments, he says. The court could also order the companies to reimburse states for drug treatment and unnecessary prescriptions paid for by Medicaid programs, he says.
“For every dollar that these companies have profited from, I want there to be a dollar that gets set aside for drug treatment,” says Hector Balderas, attorney general of New Mexico, who filed a lawsuit in September.
One significant difference between the opioid cases and the tobacco cases is that counties and cities are filing suit this time -- not just the states.
“[The tobacco] litigation was successful, but states kept all that money. None of it flowed down to the counties,” says Paul Hanly, a partner with Simmons Hanly Conroy, which is representing more than a dozen counties in opioid lawsuits and has already settled similar cases on behalf of patients.
Because he’s been here before, Hanly warns it may take longer than many might like.
“Litigation like this typically lasts three to seven years. I’d be very surprised if we were resolved by this time next year,” he says. What to Expect in 2018
In the meantime, while state and local governments fight these battles in court, drug overdose deaths are still climbing. A STAT investigation found that opioids could kill as many as 500,000 Americans in the next decade.
Jan Rader, fire chief in Huntington, W.Va., one of the cities that filed suit, says that surrounding Cabell County is expected to hit 2,000 overdose deaths this year.
“This is going to be our new normal for a while,” she says.
President Donald Trump declared the opioid epidemic a public health emergency last month, but neither he nor Congress have made extra money available for states and localities to deal with it.
Hood wishes Trump “would put his money where his mouth is” and pledge more money to combat the crisis. But he’s hopeful that drugmakers will eventually have to pay billions of dollars in damages for their role in the epidemic. He even predicts that some pharmaceutical companies will go bankrupt in the process.
“This needs to be a deterrent for the next 50 years," he says. "We have to gorge them of their profits. They need to be made an example of."

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Federal prosecutors take on pharmaceutical companies for their alleged role in opioid crisis

Nov 11, 2017 | Fox News

By Molly Line

The billionaire founder of a pharmaceutical company is the latest to face criminal charges as prosecutors seek to hold big business drug makers responsible for the role they have played in the opioid crisis.
John Kapoor, 74, resigned from the board of Arizona based Insys Therapeutics in October following his arrest. He is accused of conspiring to offer kickbacks to doctors who would then prescribe Subsys, the company's fentenyl-based spray.
"The crime here was trying to profit, for Mr. Kapoor and his co-defendants, to line their pockets by bribing doctors to sell the drug to people for whom it was not intended to be used," said William Weinreb, the acting U.S. Attorney for the District of Massachusetts.
Prosecutors say the drug was created to ease the pain of cancer patients but Kapoor knew that practitioners were pushed to prescribe the powerful narcotic to people who did not need it.
"He needs to be held accountable just the way any other drug trafficker would be held accountable," Weinreb said.
Kapoor denies any wrongdoing.
Meanwhile, Insys acknowledges the company has held talks with the government to try and come up with a resolution.
"$150 million has been accrued, which represents our best estimate of the minimum-liability exposure we expect to pay over five years," the company said.
Federal prosecutors are the latest to go after drug makers as the opioid crisis continues to spiral out of control.
More than two dozen states, cities, and counties have filed civil lawsuits against manufacturers, distributors, and drugstore chains, seeking damages to cover the cost of the ongoing opioid crisis, alleging a variety of bad or careless practices contributed to the epidemic.
Quincy, Mass. expects to file suit within weeks.
"This issue knows no boundaries. Whether it's demographic, geographic, socioeconomic. It's affected everybody at every level because it's been so easy to get pills," said Quincy Mayor Thomas Koch. "There's a million stories. I've been to way too many wakes. Every family directly has been touched by it, by a friend, by a neighbor. We're losing a generation to it."
For the last six years, the city has seen overdose deaths climb. In 2016, 42 lives were lost. At least 27 people have died so far this year.
"Whether it's the manufacturers, the distributors, to some degree into the medical profession. It was awful loosey-goosey for an awful long time. Even after we continued to see and learn of the crisis," laments Mayor Koch.
Quincy city leaders are working right now to determine just how much the opioid crisis has cost the city. They have yet to announce which pharmaceutical company or companies will be named in the suit.
"They knew what they were doing,” Koch said, “and they're going to be held accountable for it."

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The Deadly Game Big Pharma Played on the American People

Nov 12, 2017 | The Doctor Weighs IN

By Leah White

The problem of opioid abuse in this country has been growing for the past few decades, with the number of opioid-related deaths sharply increasing in the last four years. From 2014 to 2015, deaths caused by heroin overdose increased by 23% and synthetic opioids, other than methadone, increased by 73%. Some states are more affected than others. In Ohio, for example, there were 1,800 opioid-induced deaths just in the last year. This is more than any other state has ever seen before.
The CDC also reports that between 2000 and 2015, more than half million people died of an overdose in this country. Six out of ten overdoses of those overdoses are due to opioids. That means that about 300,000 people died of an opioid overdose. These numbers cannot be ignored.
While many attribute opioid overdoses to heroin, this is no longer the only pressing issue. The abuse of opioid prescription pharmaceuticals, such as oxycodone and hydrocodone, is a big part of the problem as well. Sadly, little is being done to solve this part of the equation.
Big Pharma has bought influence with the billions in profit from opioid sales, making it very difficult for government agencies like the Drug Enforcement Administration (DEA) to fight the epidemic.
Big pharma and prescription medications feed the epidemic
According to the Centers for Disease Control and Prevention, prescriptions for opioid medications almost quadrupled between the years of 1999 and 2010. The number of deaths caused by prescription opioids also more than quadrupled in that same period.
Previously, opioid therapy was reserved for rare occasions of severe pain, as practitioners feared the danger of addiction associated with these drugs. Now, opioids are commonly prescribed for fairly minor painful conditions.
Advertising, drug detailing, and lobbying, funded largely by the pharmaceutical industry, aggressively pushed to relax prescribers’ caution about writing prescriptions for opioids with the false argument that “less than 1% become addicted from opioid therapy.” Sadly, this statistic—gleaned from a note to the editor in New England Journal of Medicine—was misused. It was not peer-reviewed and was based exclusively on hospitalized patients who received controlled short-term treatment.
Big pharma pushed dangerous drugs with insufficient research and evidence of their safety because it was profitable to do so. Consider Purdue Pharma, which raked in 3.1 billion in 2010 from OxyContin sales alone. Endo Pharmaceuticals made approximately 380 million in 2011 in Opana sales. Insys has made 147.2 million in Subsys(a.k.a. fentanyl) in only the first six months of 2015, and the list goes on.
Pain prescriptions create heroin addictions
Prescription opioids interact with the brain and body in the same ways as heroin. In fact, a person with a legitimate prescription for Percocet could take it daily for only a couple of weeks and develop an addiction. And, unfortunately, prescriptions often include many more pills than needed to manage pain after procedures, such as minor surgery.
Someone addicted to a prescription opioid soon realizes that it is very expensive to acquire these drugs regularly. This is the point at which many people turn to heroin, a much cheaper option. While this jump may seem unfathomable to many, it is actually a very common narrative.
When addiction is formed, a reward loop associated with the drug develops in the brain which causes the brain to prioritize the drug above all else. A person’s judgment and logic are compromised which is how the previously absurd possibility of using heroin becomes a viable option for so many.
People drop like flies from fentanyl and carfentanyl
Fentanyl is an opioid that is 50 to 100 times stronger than morphine. Recently, many analogs of fentanyl have been manufactured in illegal labs in Mexico and distributed for illicit sale. Meanwhile, shady pharmacies and pain clinics in the U.S. are hemorrhaging opioid drugs, including fentanyl, as drugs obtained with illegitimate prescriptions wind up being sold on the streets.
Because of its high potency, fentanyl’s street presence has resulted in many more deaths than seen before in some areas. Dealers commonly sell fentanyl as heroin, while the users have no idea that it’s dangerously stronger than heroin.
Carfentanyl, an elephant tranquilizer that is 5,000 times stronger than heroin, has also made it onto the streets of some cities. This happened in Akron, Ohio, contributing to the state’s recent spike in opioid deaths. An amount equivalent to a few grains of salt can be lethal; that is how strong this drug is.
The DEA has issued a statement and warning about fentanyl, announcing that the drug is a threat to public health safety. Yet, it is legal to prescribe and distribute it in the U.S.
Big pharma fights opioid regulation & pushes pills
The state of Ohio is suing big pharma companies for “fraudulent marketing”. The accused are Purdue Pharma, Endo Health Solutions, Teva Pharmaceutical Industries and subsidiary Cephalon, Johnson & Johnson and subsidiary Jansen Pharmaceuticals, and Allergan. Ohio isn’t alone, though. Many states and cities are taking similar actions, outraged that companies pack in the cash while millions of Americans die from their products.
Pharmaceutical companies continue to market opioids dishonestly, as safe with little risk of addiction. They also inappropriately bribe and pressure doctors to prescribe opioids more often and for less severe conditions. They gift doctors with huge sums of money, disguised as payment for “speaking opportunities”, as well as with food and other items.
Now, there is a reason to believe that many big pharma companies have turned a blind eye to suspiciously big drug orders and paid to pass legislation that keeps the DEA out of these transactions. It’s time for big pharma to stop pushing their own profit incentives into medical practice.
Pharmaceutical distributors supplying opioids for illegal sale
Former DEA agent, Joe Rannazzisi, exposed some dark realities about the DEA, Congress, and big pharma during his recent appearance on a 60 Minutes segment. As the Washington Post reported, “Rogue doctors wrote fraudulent prescriptions for enormous numbers of pills, and complicit pharmacists filled them without question, often for cash.” They also reported that internet pharmacies were also giving massive amounts of prescriptions without even requiring doctor visits.
These prescription medications have been getting onto the streets and sold illegally for years now. It seems that distribution is the primary weak point in prescription drug circulation which drug dealers could take advantage of and that is exactly what has been happening.
For years, the DEA could prosecute these companies for not reporting such suspicious orders, fining them for millions of dollars and suspending their shipments. This hasn’t happened in about two years though, due to legislative changes.
As reported by 60 Minutes and the Washington Post, Rannazzissi claims that big pharmaceutical distributors—AmerisourceBergen, Cardinal Health, and Mckesson to name a few—used money and influence to persuade lawyers and DEA officials to lessen these penalties.
By hiring flip-flop lawyers who had previously worked for the DEA, pharmaceutical companies were able to challenge these tactics. Linden Barber, for example, who ran the DEA’s Diversion Control litigation office, was one of these lawyers. He quit the DEA and began selling his services to pharmaceutical companies who needed defense against the DEA’s charges.
Pharma influences law and government agencies
Near the end of April in 2015, a bill called the “Ensuring Patient Access and Effective Drug Enforcement Act,” written by Linden Barbur himself, was passed. This bill purported to grant patients more access to pain management, when over-prescription of opioid medications was already prevalent.
The bill deprived the DEA of its ability to freeze suspicious shipments and made it virtually impossible for the DEA to go after the corrupt companies making these shipments. The attorney general at the time cautioned that this law would make it more challenging to keep American people safe from opioid abuse.
The bill was considered and edited for two years, during which time “the drug industry spent $102 million lobbying Congress on the bill and other legislation,” according to the Washington Post. The Post also claims that Congressman Tom Marino, who sponsored the bill and firmly pushed it through, received $100,000 that came from the drug industry. They also say that Orin Hatch, who helped pushed the bill, received $177,000. It was passed with zero objections.
Treating opioid abuse as a dire health crisis
Now that President Trump has officially categorized the opioid crisis as a “public health emergency,” some grant money might be put towards addressing the epidemic. One effort being made is for first responders like police officers to have the life-saving drug, Naloxone (brand name Narcan), at their immediate disposal. Naloxone stops the effects of opioids, halting an overdose for long enough to save a person’s life.
Most of all, though, people need to contact senators and government officials about their dissatisfaction with the current legislation and call for new laws. We need laws that restrict opioid prescriptions more and that do not cripple the DEA from enforcing regulations. We need laws that keep big pharma manufacturers and distributors in check and the American people protected from these dangerous drugs.

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Q&A: Attorney Judy Scolnick Confronts Opioid Epidemic

Nov 10, 2017 | Connecticut Law Tribune

By Robert Storace

With Connecticut and the nation’s opioid epidemic continuing to kill people by the thousands, resulting lawsuits are also on the rise. Within the past year, at least 25 states, cities and counties have filed civil cases against manufacturers, distributors and pharmacy chains that have played a part in the $13 billion-a-year opioid industry.
One veteran lawyer on the front lines representing large municipalities is Judy Scolnick, a partner at Scott + Scott’s New York City office for the past decade. Scolnick is the lead attorney in a lawsuit filed on behalf of New Haven against Stamford-based Purdue, maker of OxyContin. Scolnick was also instrumental in filing a similar lawsuit Oct. 23 in Paterson, New Jersey. The New Haven suit comes nine weeks after Waterbury sued several pharmaceutical companies and physicians for their alleged roles in that city’s prescription drug epidemic.
Scolnick said she expects the country to see more lawsuits as users of pain-killing opiates continue to suffer fatal overdoses. Scott + Scott has been talking with residents of Connecticut, New Jersey, Massachusetts, Florida and Pennsylvania about moving forward with similar actions. She discussed the New Haven lawsuit and its merits, along with the research that went into it.
This story has been edited for length and clarity.
Q: What is the most compelling argument in your lawsuit against big pharmaceutical companies and others related to opioid use and opioid-related deaths?
A: The most compelling argument against the defendants is a misrepresentation of the safety of the product of opioid prescriptions for long-term chronic pain.
It was a very cohesive campaign of deception. There are many parts to it that were detailed in our lawsuit, such as the misuse of key opinion leaders and of organizations, that were really fronts for the manufacturers, who were putting forward the myth that opioids were safe for long-term use and with little risk of addiction. Their efforts were also successful in changing medical orthodoxy and making opioids one of the frontline defenses against chronic pain.
There was continuing medical education that was effective at changing the medical paradigm that held opioids were only to be used for very limited purposes. That’s basically for cancer pain and end-of life-care. Opioids were to be shunned for long-term chronic pain because of the high risk of addiction.
The most compelling argument against the distributor defendants is their failure to adhere to their statutory obligation to monitor and cut off the spigot of distributors when there were suspicious sales. They just continued the sales time and time again.
Q: Tell us about the research and preparation that went into putting together this lawsuit?
A: There was a lot of research. We talked with and met with experts in the field of epidemiology, as well as doctors and statisticians.
We also read a tremendous number of articles, which link opioid addiction to heroin use. We did a deep dive into the science of addiction and you can see that in our complaint. We looked at the chemical composition of morphine and heroin and the products being sold by the defendants, which were semisynthetic morphine and legal fentanyl.
We also looked at the way prescriptions were sold by the manufacturers and distributed.
Q: Take us behind the scenes with New Haven’s political leaders and public health officials. Also, tells us what surprised you the most about the opioid crisis in New Haven?
A: They are really doing heroic work in New Haven with this epidemic. They are addressing it with all the resources they have at hand.
The purpose of this lawsuit is to make sure that the resources the city has spent trying to cope with this epidemic will be replenished by the defendants, who have handsomely profited from it.
In New Haven, we dealt primarily with Corporation Counsel John Rose and his team. John is very astute and he understands the community. He also understands that the epidemic will not immediately stop when the over-prescribing stops.
What we are seeing in New Haven—and across the country—is when prescriptions are harder to get, either because of costs or because of more policing, that does not change the addict’s brain. The addicted person remains addicted, and will seek out heroin because they have to.
We need to recognize the epidemic as a public nuisance and look to the defendants to abate it, which will involve the expenditures of money. I am surprised to the extent of which the epidemic has reached into so many areas of the services of city government in New Haven.
Q: What specific proof is there that the country’s largest pharmaceutical companies engaged and conspired in a campaign to mislead the public about the dangers of opioids?
A: Medical journals are one source of proof. There have also been prior guilty pleas by Purdue Pharma and there have been a lot of settlements between Insys Therapeuticsand government agencies. There has also been consent orders for some of the defendants for upwards of hundreds of millions of dollars for off-label marketing.
There is a lot of proof already in the record. There are years of proof of wrongdoing; I think they will make a motion to dismiss, which they will lose. After that motion and when we get into discovery, it will probably be a dual between experts. But, the manufacturers will definitely have a hard time showing there was any basis for their optimistic use and overuse of opioids
Q: Are these lawsuits making a difference? Do you believe Big Pharma is committed to hunkering down and going through the legal process?
A: What we’ve seen in response to the other lawsuits is a hunker down mentality with a public relations twist. They are filing motions to dismiss. Now, about that PR twist, Purdue Pharma, for example, always says something like, “We are committed to helping resolve the opioid epidemic.” That is simply not true,
I do think there is a hunker down mentality, but also probably a realization that the litigation risk is large and increasing every day.

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Court: Travelers Off the Hook for Opioid Maker's Defense

Nov 12, 2017 | Connecticut Law Tribune

By Michael Marciano

Travelers Property Casualty Co. of America doesn’t have to pay to defend an opioid maker that was sued by two California counties and the city of Chicago.
In upholding a lower court ruling, California’s Court of Appeal, Fourth Appellate District, Division Three ruled 3-0 Monday that the Hartford,-based insurer does not have a duty to defend or indemnify Watson Pharmaceuticals. The ruling marks the company’s second victory in 15 months.
California’s Santa Clara and Orange counties, as well as the city of Chicago, have sued several pharmaceutical manufacturers and distributors, including Watson, seeking redress for costs related to the opioid epidemic in their communities. Travelers denied Watson’s demand to pay for its defense and brought a lawsuit against the company.
Travelers won a similar ruling against Watson in August, 2016, in a case that originated in Florida. In that case, the U.S. Court of Appeals for the Eleventh Circuit found the insurance carrier did not have to defend Anda Inc., a division of Watson Pharmaceuticals. The court decision was based on exclusions in the insurance policy.
In its 31-page ruling, the California Court of Appeal noted the Travelers policy covers damages for bodily injuries caused by an accident. “The California action and the Chicago action do not create a potential liability for an accident because they are based, and can only be read as being based, on the deliberate and intentional conduct of Watson that produced injuries—including a resurgence in heroin use that were neither unexpected nor unforeseen,” wrote Justice Richard Fybel.
Both the California Court of Appeal and the lower court used strong language in its critique of Watson.
“All of the injuries arose out of Watson’s products or the alleged statements and misrepresentations made about those products, and therefore fall within the product exclusions clause of the policies,” Fybel wrote.
The trial court’s comments, which were cited in the California Court of Appeals ruling, stated: “In the case at hand, the theory of both the California and the Chicago lawsuits is that Watson engaged in a well-orchestrated scheme to increase the use and sales of its opioids notwithstanding their known but undisclosed addictiveness.”
Justices William Bedsworth and Eileen Moore concurred with Fybel’s opinion.
The decision by the California court comes in the midst of numerous lawsuits that have been filed against companies that manufacture and distribute highly addictive painkillers. Within the past year, at least 25 states, cities and counties have filed civil cases against those that have reaped profit from the $13 billion-a-year opioid industry. Lawsuits on behalf of Waterbury and New Haven, Connecticut, were recently filed against those that distribute and manufacture opioids.
Los Angeles-based attorney Larry Golub, who has practiced insurance law for more than 30 years, has been watching the California case closely. Golub, who does not represent any of the parties in the California case, noted one recent ruling that went against an insurance carrier—a Seventh Circuit case out of Illinois in August 2016. In that case, the court held that Cincinnati insurance companies had an obligation to defend HD Smith, a drug wholesaler, in claims related to opioid usage.
“The takeaway is that the opioid crisis has gone into the realm of whether there is insurance coverage to pay for some of the costs being incurred by public entities,” said Golub, a partner with Hinshaw & Culbertson. “So far, at least two out of three courts have refused to pass the costs onto the insurance companies.”
“I think there is a potential for more cases,” Golub said, adding, “Big bucks are being spent to deal with the opioids crisis.”
Travelers was represented by Ronald Kent and Joshua Kroot, both with Dentons US. The insurance mega-company was also represented by Robert Kole and Jean-Paul Jaillet of Choate Hall & Stewart. None of the attorneys responded to a request for comment.
Watson was represented by Elizabeth Kim and James Murray, both of Blank Rome. Neither attorney responded to a request for comment.

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Court rules Travelers does not have to pay for opioid maker’s defense

Nov 13, 2017 | Insurance Business Journal

By Lyle Adriano

California’s Court of Appeal, Fourth Appellate District, Division Three ruled last week that Travelers Property Casualty does not have a duty to defend or indemnify Watson Pharmaceuticals.Watson Pharmaceuticals, along with several other opioid manufacturers, was sued in May by two California counties and the city of Chicago.
The claimants were seeking redress for costs related to the opioid epidemic in their respective communities. Travelers had denied Watson’s demand to pay for its defense and subsequently brought a lawsuit against the drug company.

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The California Court of Appeal detailed in its 31-page ruling that the Travelers policy covers damages for bodily injuries caused by an accident.

“The California action and the Chicago action do not create a potential liability for an accident because they are based, and can only be read as being based, on the deliberate and intentional conduct of Watson that produced injuries—including a resurgence in heroin use that were neither unexpected nor unforeseen,” Justice Richard Fybel wrote in the ruling.

“All of the injuries arose out of Watson’s products or the alleged statements and misrepresentations made about those products, and therefore fall within the product exclusions clause of the policies,” Fybel added.

“The takeaway is that the opioid crisis has gone into the realm of whether there is insurance coverage to pay for some of the costs being incurred by public entities,” commented Larry Golub, a lawyer and partner with Hinshaw & Culbertson who is unattached to the case.

“I think there is a potential for more cases,” Golub told Connecticut Law Tribune. “Big bucks are being spent to deal with the opioids crisis.”

This is the second time Travelers has won a ruling against Watson. In August 2016, the US Court of Appeals for the Eleventh Circuit ruled that the insurer did not have to defend Anda, a division of Watson Pharmaceuticals. The court based its decision on the exclusions of the company’s insurance policy.

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Shelby County Mayor Not Happy Camper Over Opioid Lawsuits

Nov 13, 2017 | Local Memphis (TN)

By Mike Matthews

Shelby County Mayor Mark Luttrell isn't saying whether he will veto the vote from commissioners, but clearly he is not a happy camper. "We've got to look at it legally and see what we can do to make it move forward," he says.
He was this close, Luttrell says. He and others in his administration had been working on plans to fight the opioid crisis. Educational programs, health programs, and yes, they were probably going to file a lawsuit.
He was given a one-hour notice before Commission Chairman Heidi Shafer announced she was filing a lawsuit without Commissioners approval.
An emergency, she said. "The only thing that was gained was a stop in the progress that was being made," Mayor Luttrell said, "... by a group of commissioners that were really outside the boundaries of their authority."
This is why he filed a lawsuit against Commission Chairman Heidi Shafer. A judge will decide whether she had the right to file a lawsuit without even a vote from the other 12 commissioners.
This is a continuation of a battle over power that's been going on between the commission and the mayor for more than a year.
Commissioners claim they are not updated by the administration, that they don't know what is going on, although this week, when Commissioner Walter Bailey wanted to hear from the mayor's people, there was an attempt to shut him down.
"We know what the administration is going to say," Commissioner Terry Roland told fellow member Bailey.
Commissioners finally did hear from the administration. "We thought we had been working with them, "Mayor Luttrell said. "They had not voiced any dissatisfaction with working with them as recently as six weeks ago. Commissioner Roland affirmed what we were doing, applauded us for what we were doing, and we appreciate that."
The mayor will decide in a few days whether he will veto a vote by commissioners supporting Heidi Shafer's decision. He says he is not worried about announcing a veto, only to have commissioners override it. "if something violates the charter," he says, "...regardless of whether they override a veto or not, we're not going to implement it."

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DEA Cutting Rx Opioid Supply in 2018

Nov 10, 2017 | Pain News Network

By Pat Anson

The U.S. Drug Enforcement Administration is going ahead with plans to reduce the supply of many opioid painkillers by 20 percent next year. That’s in addition to steep cuts in opioid production quotas the agency imposed in 2017.
In a notice quietly published this week in the Federal Register, the DEA said it would reduce the supply of many commonly prescribed Schedule II opioid painkillers, including oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine, codeine, and fentanyl. The agency said demand for the medications had dropped.
In proceeding with the cuts, which were first proposed in August, the DEA dismissed warnings from three drug makers that the reduced supplies of opioids “were insufficient to provide for the estimated medical, scientific, research and industrial needs of the United States.”
The DEA received over 100 public comments on its proposal, most of them expressing concern that any further reduction in opioids would adversely impact the availability of prescription painkillers.
“I am 75 years old, have metastatic prostate cancer in my bones and have to take high doses of fentanyl patches and morphine tablets for the chronic, intractable pain. Please do not further reduce the supply of my critical medicine,” wrote Bill Daniel.
“As a patient with multiple chronic pain conditions who already has difficulty accessing adequate pain medication due to DEA pressure on physicians, I think it is absolutely unconscionable that you would make it even more difficult for people to access the medication that we need to be able to function,” said Jenny Boettiger.
“Please stop this misguided attempt to save people from themselves. If demand is down, it's because you bullied physicians into prescribing less, not from a genuine market conditions,” wrote one anonymous poster.
“You want to cut my access to the medication I'm legally prescribed by my pain management doctors! Would you consider the same for people deemed disabled due to other illnesses? You are going to cause millions of us to either commit suicide due to unbearable pain or turn to street drugs,” said Christa Rood.
The DEA said comments such as these dealt with medical issues that were “outside of the scope” of its order and did not offer any new data for the agency to consider.
Under federal law, the DEA sets production quotas for all manufacturers of opioid medication and other controlled substances. This year the agency reduced the amount of almost every Schedule II opioid medication by 25 percent or more. The 2017 quota for hydrocodone, which is sold under brand names like Vicodin, Lortab and Lorcet, was reduced by a third.
Those cuts were not sufficient to stop the opioid epidemic, according to two letters sent to the DEA by a group of U.S. senators. The first letter, sent in July, urged that "further reductions... are necessary to rein in this epidemic.”
A second letter, sent in September, said there was "no adequate justification for the volume of opioids approved for the market." The senators asked to DEA to make the 2018 cuts in the opioid supply at least as deep as they were in 2017.
Opioid prescriptions have actually been in decline for several years. According to the Centers for Disease Control and Prevention, opioid prescribing in the U.S. has fallen by 18 percent since 2010.
In recent years, heroin and illicit fentanyl have emerged as the driving forces behind the overdose crisis, which killed an estimated 64,000 Americans in 2016. Despite that, federal efforts to prevent overdose deaths remain largely focused on reducing the use of prescription painkillers.
The CDC, for example, is spending $4.2 million on an Rx Awareness campaign in four states; running ads on billboards, radio, newspapers and online that warn about the risks of prescription painkillers. Although a recent CDC study found fentanyl was involved in over half the overdoses in ten states, the agency says it has no plans to include fentanyl or heroin in its awareness campaign.
“Our aim with this campaign is to prevent prescription opioid overdose deaths, since prescription opioids continue to be involved in more overdose deaths than any other drug. Based on studies of people entering treatment, the majority of people with opioid use disorder (including heroin use disorder) still start with prescription opioids,” CDC spokesperson Courtney Lenard said in an email.

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The Insanity of Taxpayer-Funded Addiction (EDITORIAL)

Nov 10, 2017 | The New York Times

By Editorial Board

The pharmaceutical industry was listed as one of the “Contributors to the Current Crisis” in the final report of President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis. The report cites decades of aggressive marketing and industry-sponsored physician “conferences” aimed at expanding opioid use by minimizing the dangers of addiction. Lawsuits by state attorneys general, counties and local jurisdictions allege that the industry fostered the epidemic by overpromoting its products, while raking in billions as Americans became addicted and overdosed. “To this day,” the commission says, “the opioid pharmaceutical industry influences the nation’s response to the crisis.”
It sure does. In its response to an epidemic that now kills 50,000 Americans a year, the Trump administration wants to spend tens of millions of dollars in part to help the industry responsible sell ostensibly nonaddictive pain medications and “abuse deterrent” opioids that are as addictive as the original opioids.
In a recent speech, President Trump praised a new public-private partnership involving the National Institutes of Health and pharmaceutical companies to develop nonaddictive painkillers and new treatments for addiction and overdoses. “I’ll be pushing the concept of nonaddictive painkillers very, very hard,” he promised. The N.I.H. says it hasn’t set a budget for its “public-private initiative” but spent roughly $600 million on research into pain and opioid use and abuse in 2016.
The federal Centers for Disease Control and Prevention recommends that prescribers avoid opioids for most chronic pain. Experts not affiliated with the pharmaceutical industry urge doctors to make greater use of over-the-counter analgesics and non-pharmacological pain relief methods like physical and spinal manipulative therapies, movement retraining and electrical stimulation.
In September, at a meeting in Trenton with more than a dozen pharmaceutical manufacturers to explore solutions to the crisis, the opioids commission’s chairman, Gov. Chris Christie of New Jersey, said developing nonaddictive drugs was a priority. Among the companies he hosted was Purdue Pharma. In late October New Jersey’s attorney general joined 10 other states in suing Purdue, owned by the Sackler family, alleging that Purdue deceptively marketed its drug OxyContin as safe for long-term use. “The attorney general makes those judgments, not the governor,” Mr. Christie said.Continue reading the main story
Purdue executives call abuse-deterrent opioids, along with highly effective non-opioid pain products, the “holy grail” for the pharmaceutical industry.
“Abuse-deterrent is a marketing term used to mislead,” says Dr. Adriane Fugh-Berman, a pharmacology and physiology professor at Georgetown University who directs PharmedOut, a group that monitors pharmaceutical industry marketing efforts. “At least half of prescribers think that abuse-deterrent means less addictive.” It does not; abuse-deterrent pills are simply harder to crush or alter for injection or snorting. “It doesn’t prevent you from swallowing them, which is the most common way of abusing opioids,” Dr. Fugh-Berman said.
In an email, a Purdue spokesman cited support by the N.I.H., the Food and Drug Administration and the Drug Enforcement Administration for its approach, saying that along with other pharmaceutical companies and “stakeholders” the company believes that “abuse-deterrent technologies can be one of the many effective components of a multipart approach toward combating prescription opioid abuse, misuse and diversion.”
Purdue says it supports the C.D.C. guidelines, and its chief executive, Craig Landau, said in Trenton, “I firmly believe there are too many opioids prescribed in this country.” True. And Purdue owns a large share of the responsibility for that.
The N.I.H. began its public-private initiative this summer with a series of closed-door meetings with pharmaceutical companies and academics. An N.I.H. spokeswoman, Renate Myles, said the research would include work on non-pharmacological approaches, but “we need to develop new nonaddictive medications for pain. These medications can only be brought to market with the active participation of the pharmaceutical industry.”
Purdue participated in the N.I.H. initiative. In June, in response to a call for public comments, J. David Haddox, the company’s vice president for policy, sent a letter to the commission outlining Purdue’s proposed “policy options,” including recommending that the F.D.A. “convert” the opioid market to predominately abuse-deterrent formulations.
The commission’s report includes important recommendations like expanding Medicaid coverage for inpatient treatment; expanding treatment with buprenorphine, methadone and other medications, including some still being developed; establishing a national curriculum and standards for opioid prescribers; and expanding an alternative system of drug courts that encourage treatment. Those should be the immediate priorities, not channeling money for more meds to drug companies, from the pockets of Americans whose pain was the industry’s gain.

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Medical professionals need to play a role in opioid crisis (EDITORIAL)

Nov 13, 2017 | The Salt Lake Tribune

By Leah Hogsten

First do no harm.
The Hippocratic oath is the medical community’s creed. It guides doctors to ensure that when physical and mental health is at risk, a doctor’s first concern is to not do anything to make things worse.
The onset of the opioid crisis is testing this creed. From 2013 to 2015, Utah ranked seventh in the nation for drug overdose deaths. In 2015 that meant 24 people overdosing each month. It is a crisis – a man-made one. A medical one. A Big Pharma one.
The Drug Enforcement Agency, in partnership with state agencies and community organizations, announced on Wednesday it would be focusing efforts on a new program – DEA 360. The program takes a three-pronged approach to combat opioid abuse: aggressive law enforcement, education and reduced reliance on opioid prescription as a solution to reduce pain.
Increased law enforcement is necessary, but will be least effective in actually stopping the problem. Dealers are like skinks that shed their tail when caught, run away and grow it right back. As the DEA admitted on Wednesday, they can’t arrest their way out of this problem.
And the most culpable – pharmaceutical companies – aren’t vulnerable to law enforcement.
The Department of Health and Human Services announced in September it would award up to $175,000 to 11 health centers across Utah to increase access to substance abuse and mental health treatment. As DEA 360 targets dealers, treatment centers will have more cash to actually treat those affected by addiction and pain.
An educational campaign could make a difference. But when someone is injured and suffering in an emergency room, the billboard they saw on I-15 won’t help. Few patients have the wherewithal to stop and ask a doctor whether a prescription for pain relief is the least addictive option.
Partnership with the medical community is key. To stop the problem at its source, doctors need to prescribe fewer opioids, and follow patients who use them for pain relief closer. Licensing boards need to set stronger standards, and follow up with repetitive messaging, stricter prescription guidelines and penalties with bite.
Intermountain Healthcare announced in August it will reduce the number of pills its providers prescribe for pain – 40 percent less by the end of 2018. It is a concerted and directed effort to stopgap critical mismanagement.
The answer isn’t to merely leave patients in pain. Providers need to find alternate ways to reduce pain.
A recent study concluded that for many patients, over-the-counter medications like Tylenol and Motrin worked as well as opioids for treating severe, acute pain in emergency rooms.
We shouldn’t be just learning this now.

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Texas' Big Pharma troubles (EDITORIAL)

Nov 13, 2017 | Benefits Pro

By Dan Cook

Perhaps it’s time for America’sdrug company executives to schedule a long conference call with America’s tobacco company executives to have a little chat about liability.
Big Pharma’s efforts to somehow put a lid on the brewing opioid controversyreceived a major blow in what was once a pharmaceuticals stronghold: Texas. Several (mostly rural) counties around the Lone Star state have already sued drug makers for not taking proper steps to limit the distribution of opioids within their jurisdictions. But now the topic has heated up.
What’s causing the opioid uproar in Texas is an alignment of supposedly disparate actions. The state attorney general, finally reacting to increasing opioid-related deaths and suits by several counties, jumped in on a national investigation of opioid drug manufacturers.
Meanwhile, other state elected officials began to question a 2016 state grant to a major opioid maker, McKesson, a defendant in several of the state lawsuits. Now, Gov. Greg Abbott (not related to Abbott Labs) is taking flak over his luring McKesson to expand in Texas with a $9.75 million dole-out of taxpayer dollars—a bit of economic development scheming gone horribly wrong, from a political standpoint.
Essentially, the county lawsuits claim McKesson and others failed to take proper steps to control the distribution of opioids in parts of Texas. McKesson claims it did nothing wrong and strongly opposes opioid abuse.
Blaming Big Pharma for drug overdoses, and even suing over it, is nothing new. It’s the heightened fervor with which elected officials are attacking the industry that has some drawing parallels to Big Tobacco’s legal woes in the 1990s.
With 41 states banding together to investigate the drug makers’ culpability in the crisis, legal experts are beginning to see a strategy similar to the one mounted against Big Tobacco in which Texas alone received more than $15 billion as its share of the tobacco companies’ settlement.
In an interview with the Texas Tribune, Mike Papantonio, a Florida-based lawyer with experience in tobacco litigation, suggested drug makers have left themselves wide open to litigation by not taking stronger steps to reduce opioid production and distribution.
“It’s like a polluter externalizing all his risk,” he told the newspaper. “He makes a lot of money because he pours the poison right into the river. The shareholders love it, but then the taxpayers have to come back and fix it.”
Papantonio currently serves as organizer of a legal conference for groups that may sue pharmaceutical companies over opioids, the newspaper said.
The Texas situation is particularly worrisome for pharmaceutical companies because they’ve been well-treated by the state. Now, with the governor under fire for supporting McKesson, the stronghold is collapsing.
And the McKesson grant has state officials calling for industry oversight, never a welcome development.
“There needs to be better oversight here,” said state Rep. Joe Moody (D, El Paso), a member of the new House panel examining the opioid crisis. “You’re in the middle of the opioid crisis, and we’re issuing an enormous grant that comprises a significant amount of grants this company is getting across the country.”

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State Leaves Counties to Sue Drug Companies (EDITORIAL)

Nov 11, 2017 | Urban Milwaukee (WI)

By State Senators Janet Bewley and Dave Hansen

County after county across Wisconsin is facing budget-busting costs related to the state’s opioid crisis. Jails are full and treatment centers, where they exist, are often filled beyond capacity. Time and time again we have heard from county officials that they need more from a state government that has too often left them to face this crisis on their own.
Hampered by state revenue limits, counties are often forced into costly borrowing to cover the costs of transporting and housing Wisconsinites caught up in this epidemic in other parts of the state. And property taxpayers are forced to pick up the cost.
While we agree that individuals must bear the responsibility of their decisions, big pharmaceutical companies like Purdue Pharma must accept their responsibility in helping create the current opioid crisis.
For over a decade pharmaceutical companies used deceptive practices to knowingly promote the use of dangerous opioids for a wide variety of less severe, longer term pain conditions even though they knew their products were highly addictive and subject to abuse. It is no coincidence that after all these years we are now experiencing the worst opioid crisis in our history.
Several months ago, the Legislature took up a well-meaning package of bills in special session to address the public health crisis. We put forward an amendment to one of the bills calling on the Attorney General to report on prospects for suing pharmaceutical companies for their role in the explosion in opioid prescriptions, addictions… and profits.
This could have been an opportunity to ensure these companies do not shirk their responsibility for the costs of the opioid crisis off onto Wisconsin taxpayers. But that amendment was defeated on party lines.
The next morning the Attorney General announced he would investigate the possibility of a lawsuit.
That was in June, back when the Brewers were in first place and summer was in full swing. The World Series has ended, Wisconsin kids are long since back in school and counties are facing this crisis with no more help than they had this summer. It’s long past time to stop considering action and time to take it.
Since then, more than two dozen Wisconsin counties have taken matters into their own hands, joining a lawsuit against pharmaceutical companies. Briefed on the lawsuit last month, county officials discussed the enormous impacts on law enforcement, foster care, emergency medical services, mental health issues, court services and national estimates showing the costs of the crisis approaching $80 billion.
Wisconsin citizens and taxpayers are well-served by local officials acting for the public good. It’s time for their partisan counterparts in Madison to do the same. We are disappointed that the Attorney General has left it to county officials and taxpayers to seek responsibility from Big Pharma on their own.
During our Senate debate of the state budget this fall, we put forward another amendment with Senator Chris Larson of Milwaukee that would have again asked the Attorney General to join his colleagues in other states and in a growing number of Wisconsin counties by calling pharmaceutical companies to task for their role in this crisis. That amendment would have dedicated any judgement to local costs, reducing the burden on your property taxes and putting the responsibility for this crisis where it belongs.
That amendment, again, was defeated along party lines.
We will be calling on the Attorney General to consider specifically what steps the state can take to alleviate the budget crisis at the county level brought on by the opioid epidemic. We will be pushing for action from the Attorney General to hold Big Pharma accountable.
We took important steps this spring to help families face opioid addiction with the backing of increased resources and compassionate laws. It’s time now for the Attorney General to step up to make sure that counties and property taxpayers do not face this burden alone.

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Is There A Way To Keep Using Opioid Painkillers And Reduce Risk?

Nov 13, 2017 | WNYC (NY)

By Allison Aubrey

AUDIO (3 Min): http://www.wnyc.org/story/is-there-a-way-to-keep-using-opiod-painkillers-and-reduce-risk/
Jon McHann, 56, got started on prescription opioids the way a lot of adults in the U.S. did: he was in pain following an accident. In his case, it was a fall.
"I hit my tailbone just right, and created a severe bulging disc" that required surgery, McHann says.
McHann, who lives in Smithville, Tenn., expected to make a full recovery and go back to work as a heavy haul truck driver. But 10 years after his accident, he's still at home.
"After the surgery the pain was just excruciating," McHann recalls. "I was unable to function." His spinal problems turned out to be more complicated and hard to treat. And he developed other health problems, too. He had several more surgical procedures for his back, but he got no relief. He says on days when his pain is through the roof, "I can't open my eyes because I know if I blink it's going to hurt."
His doctor prescribed methadone, a powerful opioid. He stayed on the drug for seven years.
"It helped immensely, it brought my pain down to a 5 or 6 [on a 10 point scale]," McHann says. "I could function fairly well throughout the day. I could go to church every weekend, I could help my wife shop, I could help around the house a little bit."
McHann knew the risks of opioid drugs, including the risk of dependence. "It was a concern to me," he says. His goal was to get off the drugs. But for many years, it felt like the benefits of the pain relief outweighed the risks.
But as concern about the opioid epidemic grew, McHann started getting pushback from his doctors. They began reducing the strength and dose of his prescription "Every time I saw a clinician, my opioids were reduced," McHann says.
As the dosage was decreased, his pain began to increase and he worried that he'd be cut off the drug. "Life wasn't going to be worth living if I couldn't get the pain under control," McHann says.
McHann is not alone; pain is one of the most common and debilitating medical conditions, with about one-third of Americans dealing with some form of acute or chronic pain. In 2014, 3 to 4 percent of adults were prescribed opioid painkillers long term — 9.6 to 11.5 million people.
In response to the epidemic of opioid addiction and deaths, in 2016 the Centers for Disease Control and Prevention released guidelines urging physicians to try non-opioid methods first for chronic pain. In a viewpoint published last month in JAMA, the journal of the American Medical Association, CDC officials wrote that while illicit opioids such as fentanyl seem to be driving the recent increase in opioid-related overdose deaths, "unnecessary exposure to prescription opioids must be reduced to prevent development of opioid use disorder in the first place."
But figuring out what's unnecessary, and how best to reduce the risk, can be a challenge.
"I have certainly met a good number of patients who have not found better options and are now taking opioids for chronic pain," says Stefan Kertesz, a physician who is a professor at the University of Alabama at Birmingham, certified in addiction medicine.
Kertesz, who is not McHann's doctor, says some physicians feel caught between a rock and a hard place. With the rise in opioid overdose deaths, there's a lot of pressure to limit prescriptions.
The CDC guidelines point to the serious risks of high dosages and long-term use, including addiction. They offerguidance to physicians on how to taper doses, or discontinue the use of the drugs.
Kertesz agrees that opioids have been prescribed too much in the past. "Absolutely, [doctors] caused new addiction in some people by prescribing too aggressively," Kertesz says. "But the idea that you can simply take [the drugs] away, sometimes from people who need them, is mistaken."
Kertesz' position is controversial. His stance led me to wonder whether he had had ever worked for the pharmaceutical companies that promoted these drugs? "I have never worked a day in my life for the pharmaceutical industry and I have no interest in doing it in the future," Kertesz says. "Do I want to be in situation where I'm forced to take people off a medicine that is helping them? No! "
Going forward, Kertesz says he hopes that new medications will be developed that will have less potential for addiction, "but I think human suffering is really complicated and doctors need to have the room to make professional decisions — together with their patients — about what works best for them."
As for Jon McHann, last month he had another procedure aimed at easing nerve compression in his back, and for now he's optimistic. His pain is diminished, and he's on a much lower dose of medication. He's taking Percocet, which gives him a lower dose of opioids and acetaminophen. "I'm hoping to be opioid free, I don't know if I'll get there, but I want to try."

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Brain Scientists Look Beyond Opioids To Conquer Pain

Nov 13, 2017 | WNYC (NY)

By Jon Hamilton

The goal is simple: a drug that can relieve chronic pain without causing addiction.
But achieving that goal has proved difficult, says Edward Bilsky, a pharmacologist who serves as the provost and chief academic officer at Pacific Northwest University of Health Sciences in Yakima, Wash.
"We know a lot more about pain and addiction than we used to," says Bilsky, "But it's been hard to get a practical drug."
Bilsky is moderating a panel on pain, addiction and opioid abuse at the Society for Neuroscience meeting in Washington, D.C., this week.
Brain scientists have become increasingly interested in pain and addiction as opioid use has increased. About 2 million people in the U.S. now abuse opioids, according to the Centers for Disease Control and Prevention.
But at least 25 million people suffer from chronic pain, according to an analysis by the National Institutes of Health. That means they have experienced daily pain for more than three months.
The question is how to cut opioid abuse without hurting people who live with pain. And brain scientists think they are getting closer to an answer.
One approach is to find drugs that decrease pain without engaging the brain's pleasure and reward circuits the way opioids do, Bilsky says. So far, these drugs have been hampered by dangerous side effects or proved less effective than opioids at reducing pain.
But substances related to snail venom look promising, Bilsky says.
The cone snail uses its venom to paralyze fish. And scientists discovered that this venom contains substances that act as powerful painkillers. And because these substances do not affect the same brain circuits that opioids do, they have the potential to be much less addictive.
At least one drug related to snail venom is already on the market, though it's not widely used because it must be injected into the spinal column.
Another new approach to pain management involves targeting brain circuits that can amplify or dampen our perception of pain.
Scientists have known for a long time that when someone is fearful and anticipating pain – say, during a trip to the dentist – they will experience more discomfort. That's because fear and expectation circuits in the brain can amplify the pain signal coming from a tooth or some other area.
Depression and isolation can also amplify pain, Bilsky says. "If a person in pain stays home instead of going to their mahjong group, that feeds an escalation in pain," he says.
And there's evidence that chronic pain can change the brain's wiring in a way that makes a person more sensitive to any future injury.
So brain scientists are looking for ways to tweak the brain circuits that affect our perception of pain.
Already, doctors often prescribe antidepressant drugs to people with chronic pain. And researchers are trying drugs that help the brains of people with chronic pain "forget" past pain.
They are also looking for ways to erase memories of pain.

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Broadcast Media Coverage

2 News at 5:30am

Nov 13, 2017 | KUTV (CBS)

By Salt Lake City, UT

Video Link: http://app.criticalmention.com/app/#clip/view/30649960?token=ac5e6192-da7d-44cf-a139-918fa1f68c5f
Rough Transcript: happening today... today, salt lake county wiljoin the national fight against opioid makers. this afternoon, county mayor ben mcadams and other utah leaders will join families affected by the opioid crisis. they will announce the county's plan to pursue legal action against opioid drug manufacturers. we will bring you more about today's announcement on 2news at 5 o' clock.

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Good Morning Acadiana

Nov 13, 2017 | KATC (CBS)

By Lafayette, LA

Video Link: http://app.criticalmention.com/app/#clip/view/30649996?token=ac5e6192-da7d-44cf-a139-918fa1f68c5f
Rough Transcript: louisiana is rated top twenty states in the u-s for highest number of drug related deaths. in fact-- according to the cdc-- there are more opioidprescriptions than actual residents. dannielle garcia sat down with the governor and attorney general... who say it's high time for change 7:35 AMnat open gov it touches every family of every size, every community in the state of louisiana and its something we need to get a grip on because its starting primarily through prescription opioids state officials say legal prescription drugs are leading to deadly addiction habits. nearly 80% of american heroin users reported their abuse began with prescription pain medication, according to the national institute on drug abuse ag prescription pills started this epidemic now we ave illegal drugs entering into the market, fetanol and heroine and i think corporate america has a responsibility to help curb this epidemic and should be involved nearly two months ago-- the department of health filed a lawsuit against major drug manufaturers. according to the suit, louisiana spent $297 million in health care costs alone due to opioid abuse . that number does not clude the costs that are crippling the criminal justice system the suit claims-- instead of revealing the uth about the addictiveness of prescription pills, they provided falsestatements to maximize profits above the health of their customers gov the president is right it is a public health emergency.but you also have local sheriffs offices and parish governments for example that have incurred damages as well because of the way pharma companies pushed these opioids in such high numbers into our community as they did around the country and now the attorney general is seeking control of that lawsuit. ag its very problematic, nowhere in the country are you seeing governors getting involved as far as leading it's the attorney generals and the reason is the attorney generals are leading because they are the chief legal officers of the state. " 7:36 AMwell since the lawsuit was filed we've had multiple meetings with the attorney general " meanwhile separately each have taken steps to fight the opioid epidemic in their own way. opioids are typically prescribed for pain relief... and edwards says under the medicaid expansion, physicians are prescribing fewer prescriptions per person if you have more health insurance youre going to have more healthcare. and so there are going to be more people who will be prescribed pain pills as they were before. but under the new rules we have in place this past eyar those prescriptions were ilmited to 7 days where as they werent similarly limited before. the governors office also signed two other bills.. one that created an advisory council on opioid abuse prevention-- and another which requires doctors to get more training. meanwhile the attorney general already settled one lawsuit started by the previous attorney general against a drug company. ag litigation costs a lot of money it costs the tax payers a lot of money if theres a way we can come to a resolution absent litigation you always want to do that.... this case is about whether or not these manufacturers put out information to doctors that said that these opioids were not addictive and they could be prescribed for modderate to severe pain without any fact that the patient could be addicted to it standup: according to the cdc, louisiana went from 188 drug related deaths in 1999 to 861 in 2015... state officials say that increase is at the hands of pharmaceutical companies gov well we want to make sure this epidemic ends. that we arent needlessly causing people to become addicted to opioids. that we arent causing people to go onto the street and access heroin for example.and is leading to a bunch of over dose deaths as well it is costing lives. people are losing their children their friends their parents and its time for us to come together figure out a way to stem this epidemic then do something about it.

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