Preview Newsletter
Opioid Litigation Daily Media Report - 12/1/17
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County attorneys in Minnesota sue opioid manufacturers, distributors
Nov 30, 2017 | MPR News (MN)
By Tim Nelson
A group of Minnesota county attorneys announced lawsuits Thursday against the manufacturers and distributors of opiate-based pain medications. -
Minnesota Prosecutors Sue Drug Companies Over Opioid Crisis
Nov 30, 2017 | Associated Press
By Staff
A group of Minnesota county attorneys are suing drug distributors and manufacturers over the opioid crisis. -
Minnesota county attorneys plan lawsuits over opioid crisis
Nov 30, 2017 | Pioneer Press
By Christopher Magan
Minnesota county attorneys from across the state plan to sue opioid manufacturers and distributors for allegedly using marketing tactics akin to the tobacco industry to flood communities with addictive and deadly narcotics. -
20 Minnesota Counties To Sue Opioid Producers
Nov 30, 2017 | WCCO CBS Minnesota
By Angela Davis
A public health crisis in Minnesota has turned in a legal fight. -
Minnesota county attorneys file lawsuits against pharmaceutical companies
Nov 30, 2017 | Fox 9 (MN)
By Karen Scullin
In a passionate press conference, more than a dozen Minnesota county attorneys announced they filed civil lawsuits against manufacturers of prescription painkillers, accusing them of contributing to the opioid crisis in Minnesota. -
Rubin Speaks At State Opioid Conference
Dec 1, 2017 | KDAL (MN)
By Dave Strandberg
St. Louis County Attorney Mark Rubin presented the Greater Minnesota perspective on the opioid crisis in Minnesota during a conference on the subject in St. Paul Thursday. -
County attorneys in Minnesota file lawsuits against opioid manufacturers
Dec 1, 2017 | Star Tribune (MN)
By Pam Louwagie
County attorneys in Minnesota announced lawsuits Thursday against drug manufacturers and distributors for the public cost of the opioid crisis sweeping the nation. -
Minnesota counties to sue opioid manufacturers
Nov 30, 2017 | Woodbury Bulletin
By Katie Nelson
Washington County, along with about 20 other Minnesota counties, announced civil action against major pharmaceutical companies Nov. 30 for the sale and manufacture of opioid drugs. -
Brown, Outagamie counties could join 48 counties' lawsuit against opioid drug-makers
Nov 30, 2017 | Green Bay Press-Gazette (WI)
By Doug Schneider
Brown and Outagamie counties could soon join a lawsuit against the makers of pain-killing opioid drugs, pushing the number of counties suing the companies to 50. -
More Wisconsin counties join suit against big pharmaceutical companies
Dec 1, 2017 | News8000.com (WI)
By Mal Meyer
Twenty more Wisconsin counties have filed lawsuits against big pharmaceutical companies alleging that the businesses engaged in deceptive marketing campaigns to push their products. The counties are asking for money from the companies to pay for an increase in services provided due to the opioid epidemic. -
Purdue Pharma Discloses Negotiations With AGs on Opioids
Nov 30, 2017 | Bloomberg
By Jef Feeley and Jared S. Hopkins
Purdue Pharma LP acknowledged in a letter that the maker of the opioid painkiller Oxycontin is in “negotiations’’ with state attorneys general over lawsuits accusing the company of creating a public-health crisis with its mishandling of the drug. -
JPML Open To Opioid MDL Despite Concerns About Size
Dec 1, 2017 | Law360
By Diana Novak Jones
The Judicial Panel on Multidistrict Litigation seemed to lean toward centralizing litigation stemming from the country’s opioid crisis during arguments at the panel’s hearing in St. Louis on Thursday, but the judges repeatedly asked for guidance on how to work with the large variety of potential defendants and plaintiffs. -
County suing companies that make, distribute opioids
Dec 1, 2017 | News-Press Now (MO)
By Marshall White
Buchanan County commissioners are taking action to address the local public health crisis known as the “opioid epidemic.” -
County could sue drug companies over opioids
Dec 1, 2017 | The Record Delta (WV)
By Katie Kuba
Who’s to blame for the opioid epidemic devastating the Mountain State — drug distributors that manufacture and market the painkillers on which so many West Virginia residents have gotten hooked or the doctors who prescribe them? -
Some counties joining lawsuits against drug companies
Nov 30, 2017 | The Effingham Daily News (IL)
By Graham Milldrum
Americans die of opioid overdoses at a rate of 91 per day. Local communities are casting about for tools to protect their citizens. One that has increased in popularity is suing the companies responsible for producing and distributing opioid medications. -
Opioid manufacturers face first-of-its kind lawsuit from Mississippi hospital
Nov 30, 2017 | Clarion Ledger (MS)
By Anna Wolfe
Like it did against Big Tobacco in the 1990s, Mississippi is helping lead the fight against opioid manufacturers amid an epidemic killing nearly 100 Americans each day. -
Local hospitals involved in lawsuit against opioid distributors and manufacturers
Dec 1, 2017 | WPMI NBC 15 (AL)
By Staff
A class action lawsuit has been filed to shift the cost of the opioid crisis from hospitals to those it alleges are responsible- several of the leading opioid distributors and manufacturers in the country. The suit is filed on behalf of two area hospitals and an area medical group. -
County readies to sue opioid makers
Dec 1, 2017 | The Chronicle-Telegram (OH)
By Scott Mahoney
The Lorain County commissioners are joining the growing number of municipalities that are suing the manufacturers and distributors of prescription opiates. -
Mt. Lebanon forum features attorney general addressing opioid crisis
Nov 30, 2017 | The Almanac (PA)
By Harry Funk
As Pennsylvania’s top law enforcement official, Attorney General Josh Shapiro makes it a priority to tackle what he believes to be the state’s No. 1 public safety and public health threat: the heroin opioid epidemic. -
He Took Opioids To Manage His Chronic Pain. When His Doctors Took Them Away, He Didn’t Want To Live Anymore.
Nov 30, 2017 | BuzzFeed News
By Dan Vergano
In the midst of an opioid epidemic, doctors are caught in a fierce debate over whether to stop medications for patients with chronic pain. Here’s what happened to one man when his painkillers were taken away. -
Trump donates third-quarter salary to HHS opioid efforts
Nov 30, 2017 | POLITICO
By Cristiano Lima
President Donald Trump has donated his third-quarter presidential salary to the Department of Health and Human Services’ efforts to combat the opioid crisis, the department and the White House announced Thursday. -
Doctors and the opioid crisis: An AJC National Investigation
Dec 1, 2017 | Atlanta Journal-Constitution (GA)
By Carrie Teegardin
An investigation by The Atlanta Journal-Constitution found that opioid-related overdoses in the state of Georgia claimed the lives of 982 people last year. The AJC also found that doctors aren't being held accountable when they behave more like dealers than healers. -
America's Opioid Crisis: A Nation Hooked
Nov 30, 2017 | Forbes
By Neil Howe
In a speech last month, President Trump declared America’s opioid crisis a national public health emergency, telling observers that “nobody has seen anything like” it. He’s right: The opioid epidemic is being called the worst public health crisis in American history, with its lethal consequences exacting a toll on users, families, and law enforcement nationwide. Though the affected span all ages, it’s Boomers (and early-wave Xers) who are pushing up overdose rates the most—a divergence from typical demographic patterns and a reflection of a risk-taking ethos that has followed these generations into maturity. -
New DEA Office to Open in Epicenter of Opioid Crisis
Dec 1, 2017 | The Washington Free Beacon (D.C.)
By Charles Fain Lehman
The Drug Enforcement Agency will open its 22nd division office next year in Louisville, Kentucky, bringing agency resources and focus to three states hardest hit by the nationwide opioid epidemic. -
Ahlquist Targets Opioid Crisis
Dec 1, 2017 | Coeur d'Alene Press (ID)
By Mike Patrick
Candidate Ahlquist reverted to Dr. Ahlquist during an editorial board meeting Thursday at The Press. -
5 Eyewitness News
Dec 1, 2017 | KSTC (MN)
By Minneapolis-St. Paul, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31102815?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
News 8 This Morning
Dec 1, 2017 | WKBT (CBS)
By La Crosse, WI
Video Link: https://app.criticalmention.com/app/#clip/view/31102821?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
45 News Morning
Dec 1, 2017 | KSTC
By Minneapolis-St. Paul, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31102906?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
Fox 21 Local News
Dec 1, 2017 | KQDS (FOX)
By Duluth, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31102917?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
FOX 9 Morning
Dec 1, 2017 | KMSP (FOX)
By Minneapolis-St. Paul, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31102920?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
KARE 11 News Sunrise
Dec 1, 2017 | KARE (NBC)
By Minneapolis-St. Paul, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31102922?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
KBJR 6 and Range 11 News at Ten
Dec 1, 2017 | KBJR (NBC)
By Duluth, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31103060?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
KEYC News 12 at Ten
Nov 30, 2017 | KEYC (CBS)
By Mankato, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31106437?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
News 12 at Nine on FOX 12 Mankato
Nov 30, 2017 | KEYCDT2 (FOX)
By Mankato, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31107010?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
WCCO 4 News at Six
Nov 30, 2017 | WCCO (CBS)
By Minneapolis-St. Paul, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31108108?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
Eyewitness News at Five
Nov 30, 2017 | WDIO (ABC)
By Duluth, MN
Video Link: https://app.criticalmention.com/app/#clip/view/31108154?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
KCCI 8 News at Five
Nov 30, 2017 | KCCI (CBS)
By Des Moines, IA
Video Link: https://app.criticalmention.com/app/#clip/view/31108112?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
UpNorth Live News at 6:30pm
Nov 30, 2017 | WGTQ (ABC)
By Traverse City, MI
Video Link: https://app.criticalmention.com/app/#clip/view/31108110?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
7&4 News at 5PM
Nov 30, 2017 | WPBN (NBC)
By Traverse City, MI
Video Link: https://app.criticalmention.com/app/#clip/view/31108161?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
KQ-2 News at Ten
Nov 30, 2017 | KQTV (ABC)
By St. Joseph, MO
Video Link: https://app.criticalmention.com/app/#clip/view/31106508?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
Hometown This Morning
Dec 1, 2017 | KQTV (ABC)
By St. Joseph, MO
Video Link: https://app.criticalmention.com/app/#clip/view/31102934?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
WMC Action News AM at 6AM
Dec 1, 2017 | WMC (NBC)
By Memphis, TN
Video Link: https://app.criticalmention.com/app/#clip/view/31102925?token=0bcb3da4-b36e-4f50-a000-247decfd83ba -
Local 15 News at 10pm
Nov 30, 2017 | WPMI (NBC)
By Mobile, AL
Video Link: https://app.criticalmention.com/app/#clip/view/31104066?token=0bcb3da4-b36e-4f50-a000-247decfd83ba
Minnesota Counties
Wisconsin Counties
Opioid MDL
Other Litigation Coverage
Commentary and FYIs
Broadcast Media Coverage
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County attorneys in Minnesota sue opioid manufacturers, distributors
Nov 30, 2017 | MPR News (MN)
By Tim Nelson
A group of Minnesota county attorneys announced lawsuits Thursday against the manufacturers and distributors of opiate-based pain medications.
"We've had enough of the fraudulent marketing and negligent distribution of opioids, and all of us have had enough of the devastation that's been perpetrated on our communities," Washington County Attorney Pete Orput said at a press conference in St. Paul.
He said the group would try to recoup the government's cost of dealing with the addiction crisis from three distributors and more than a half dozen manufacturers. Ramsey County Attorney John Choi said several Twin Cities law firms have agreed to join the legal effort and the suits would be filed in state and federal courts.
Orput said opioids have a legitimate use for post-surgery pain and end-of-life care, but that manufacturers told family physicians and other providers that the drugs were also useful for chronic pain and long-term use, while downplaying the risk of addiction.
He called it a "widespread and deeply deceptive marketing campaign."
"I'm willing to prove that and so are my colleagues," Orput said. "We've got ourselves a public health epidemic. There's more than a correlation that when the opioid marketing went up ... so did the heroin epidemic."
A number of manufacturers issued statements in response to requests for comment from MPR News, saying they only support the appropriate use of the medications for pain relief, and try to prevent illegal sales.
A statement from the Healthcare Distribution Alliance's senior vice president John Parker said the trade group is ready to work with political leaders, but "we aren't willing to be scapegoats."
"Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated," Parker said.
Orput was joined by county attorneys from Ramsey, Olmsted, Dakota, Carver and Mower counties. The group said they expect about 20 of the state's 87 counties to join the legal effort.
St. Louis County Attorney Mark Rubin said there were 12 opioid-related deaths recently in Duluth alone.
"This is not just a metro problem. Between 2012 and 2016, in greater Minnesota, 607 people died because of an opioid related overdose," he said. More than 100 of those deaths were in St. Louis County.
Ramsey County commissioner Victoria Reinhardt compared the opioid addiction problem to pollution. "They must clean up their mess. They created it, they need to fix it," she said. "You have to figure out what to do with it in the end. It's not on the taxpayers."
Hennepin County Attorney Mike Freeman said prosecutors are pursuing more third-degree murder charges in overdose death cases as a tool to stem the epidemic. Freeman said his office alone will bring 21 such cases this year. He also said authorities plan to launch a public education campaign, comparable to recent efforts to curb methamphetamine use.
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Minnesota Prosecutors Sue Drug Companies Over Opioid Crisis
Nov 30, 2017 | Associated Press
By Staff
A group of Minnesota county attorneys are suing drug distributors and manufacturers over the opioid crisis.
The goal is to try to recover the government's cost of dealing with opioid addiction, which prosecutors say increased when drug companies amped up their marketing for opioids as a way to treat chronic pain and for long-term use.
Washington County Attorney Pete Orput says there's a correlation between that marketing and the opioid epidemic that has killed hundreds in Minnesota.
The group says they expect about 20 of the state's 87 counties to join the effort.
Several other local governments across the country have filed similar claims, alleging that manufacturers and distributors of prescription opioids are largely responsible for the problem. Representatives for the defendants have denied any wrongdoing in other cases.
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Minnesota county attorneys plan lawsuits over opioid crisis
Nov 30, 2017 | Pioneer Press
By Christopher Magan
Minnesota county attorneys from across the state plan to sue opioid manufacturers and distributors for allegedly using marketing tactics akin to the tobacco industry to flood communities with addictive and deadly narcotics.
At a news conference Thursday, Washington County Attorney Pete Orput said he feared late-night phone calls because so often it’s law enforcement contacting him about “another dead kid” who overdosed.
“We’ve had enough of the fraudulent marketing and negligent distribution of opioids,” Orput said. “All of us have been struggling with the devastating affect they’ve had on our communities. All of this has been done in the name of outrageous profits.”
Last year, 395 Minnesotans died from opioid overdoses, according to the most recent data from the state Department of Health. Roughly half of those deaths were from prescription drugs sold under brand names such as Oxycontin and Percocet and Vicodin.
In 2016, Minnesota health care providers wrote 3.5 million prescriptions for opioids, enough for 62 percent of the state’s population to have access to the powerful drugs, state data shows.
The county attorneys’ lawsuits will allege that flood of pills is due to a dishonest campaign stretching back to the late 1990s to convince doctors and patients that opioids were not addictive and were a safe way to treat chronic pain.
Easy access to pills led to widespread opioid dependence with addicts often turning to illicit drugs when their prescriptions ran out, the county attorneys claim.
Pharmaceutical companies had a duty to tell doctors and patients the truth about the possible dangers of their products and should never put profits over safety, Orput said.
“That hasn’t happened. The defendants broke those simple rules,” he said.EACH COUNTY HAS ITS OWN STORY
Ramsey County Attorney John Choi said county leaders decided to pursue individual lawsuits against opioid manufacturers and distributors because the drugs have had different impacts in each community. Counties also have the option of filing lawsuits in state or federal courts.
Lawsuits are expected to be filed across the state in the coming weeks.
“Every county is going to have a different story to tell with respect to their claims against distributors and the manufacturers,” Choi said, noting that county leaders were sharing information. “We are very much together and we want to find solutions that are going to work for our communities.”
Officials from Ramsey, Washington, Dakota, Hennepin and St. Louis counties all attended Thursday’s news conference to announce the lawsuits.
Minnesota is not the only state to file lawsuits against opioid manufacturers. There are scores of lawsuits that have been filed nationwide, and in at least one case they have led pharmaceutical companies to change their marketing practices, Minnesota officials said.DRUG MAKERS HAVE DENIED WRONGDOING
Minnesota’s lawsuits seek financial damages and better oversight of opioids to address what is described as a public health epidemic. Defendants include the Purdue Frederick Company; Cephalon, Inc.; Janssen Pharmaceuticals; Watson Laboratories; the McKesson Corporation and others.
In other cases opioid manufacturers and distributors have denied wrongdoing. Earlier this year, McKesson agreed to a record $150 million civil settlement with the Justice Department for failing to report suspicious sales of opioids.
“We must hold these corporate schlockmeisters accountable,” Orput said, using a slang term for a junk dealer.
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20 Minnesota Counties To Sue Opioid Producers
Nov 30, 2017 | WCCO CBS Minnesota
By Angela Davis
A public health crisis in Minnesota has turned in a legal fight.
Twenty Minnesota county attorneys announced Thursday that they are suing the companies that make and distribute opioids.
Opiate-based pain medications are powerful and highly addictive. Some drug companies are now facing a flurry of civil lawsuits.
The death of Prince last year from an accidental overdose of an opioid pain medication, was a wake-up call — provoking many to ask questions about prescription painkillers like fentanyl and oxycodone.
Janie Colford knows the dangers of opioids all too well.
“It just puts your family in chaos, in and out of chaos, because the cycle is recovery, relapse, recover, relapse,” she said.
She serves on the board of a non-proft dedicated to ending addiction and overdose deaths. Her nephew died of an opioid overdose and her son has struggled with addiction for years.
And while they may not have been prescribed opioids, Colford said they were readily available.
“The reason they were even around opioids — opioids were around is because they were being prescribed so plentifully, irresponsibly,” she said.
She thinks it’s past time county attorneys hold the opioid drug manufacturers and distributors liable.
“This is a public nuisance and they need to help us clean it up,” said Washington County Attorney Pete Orput.
County attorneys and commissioners announced their plans to file civil lawsuits in each of their counties: Ramsey, Hennepin, Washington, Dakota, Mower and St. Louis.
Their target is opioid drug manufacturers and distributors, who they accuse of fraudulent marketing and negligent distribution.
“What we seek by filing these suits is accountability and restitution, that’s what we’re looking for,” Orput said. “This isn’t a money grab. This is asking them to help us pay for the crisis they’ve put in our laps.”
Last year, 395 Minnesotans died from an opioid overdose, and half of them from prescription pills.
“I got to tell you, it’s so bad that when my phone rings at night, I go into post traumatic stress because it will be something like [Washington County Sheriff Dan Starry] calling and saying, ‘Another dead kid, Pete, another dead kid,'” he said.
The Duluth area has seen the impact opioid addiction is having families and child protective services.
“This is affecting the babies in our community,” said the St. Louis County Attorney Mark Rubin. “Neonatal abstinence syndrome. Babies are being born addicted to these drugs.”
More counties are expected to file lawsuits, which seek restitution for the expenses from the opioid crisis from law enforcement costs and social services to medical care and treatment of patients.
About 70 similar lawsuits have been filed across the nation.
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Minnesota county attorneys file lawsuits against pharmaceutical companies
Nov 30, 2017 | Fox 9 (MN)
By Karen Scullin
In a passionate press conference, more than a dozen Minnesota county attorneys announced they filed civil lawsuits against manufacturers of prescription painkillers, accusing them of contributing to the opioid crisis in Minnesota.
“We must hold these corporate shlockmeisters responsible for their rapacious profiteering that has directly contributed to deaths, family breakups, hospitalizations and addictions,” said Pete Orput, Washington County Attorney.
Orput led the charge, but actually about twenty counties filed civil lawsuits against a long list of drug manufacturers and distributors for deceptive marketing.
“Those manufacturers through their aggressive and fraudulent marketing convinced thousands of physicians to write millions of prescriptions, which has led the us to consume four-fifths of all opioids in the world, yet we're only 4.6 percent of the population,” he said.
Between 1999 and 2014 more people died from prescription painkillers than heroin or other opioids. Over half of the overdoses in 2016 were opioid-related, which was up 12 percent from 2015.
“I gotta tell you it's so bad that when my phone rings at night I go into post-traumatic stress because it will be something like Sheriff Starry calling me with something like, ‘Another dead kid Pete, another dead kid,’” said Orput. “Well how many is enough?”
The crisis is not just in the metro area. Thursday evening, Duluth will hold a community meeting to teach residents how to use Narcan, the drug used to reverse an opioid overdose and hopefully save a life.
“And when you go home you can take a kit with you,” said Mark Rubin, St. Louis County Attorney. “How sad is that? That this is what is happening in our community.”
All counties are asking for accountability and restitution. They want the drug companies to help pay to fix what is now a major crisis.
Fox 9 received statements from several of the drug makers who say they are active in fighting addiction and deny any wrongdoing. Similar lawsuits are being filed in other cities and states around the nation, most of them have not been resolved. West Virginia did reportedly come to a settlement with 14 drug manufacturers, walking away with $40 million.
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Rubin Speaks At State Opioid Conference
Dec 1, 2017 | KDAL (MN)
By Dave Strandberg
St. Louis County Attorney Mark Rubin presented the Greater Minnesota perspective on the opioid crisis in Minnesota during a conference on the subject in St. Paul Thursday.
The news conference was held to announce civil action being taken by Minnesota Counties against manufacturers and distributors of opioid based pain medication.
St. Louis County will join several other counties in the lawsuits before the end of the year. The court action was approved by the County Board on November 14th.
Officials say there were 167 overdose deaths in the county between 2011 and 2016 from heroin, opioids and other prescription pain medication.
Rubin says the lawsuit will help curtail the use, abuse and illegal diversion of the drugs. Financial recovery could result in increased education, treatment, social services and help in reimbursing law enforcement costs.
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County attorneys in Minnesota file lawsuits against opioid manufacturers
Dec 1, 2017 | Star Tribune (MN)
By Pam Louwagie
County attorneys in Minnesota announced lawsuits Thursday against drug manufacturers and distributors for the public cost of the opioid crisis sweeping the nation.
About a half-dozen county attorneys and other public officials from across the state formally announced the legal actions at a news conference in St. Paul, saying they wanted to show a united front against the companies, which they allege fraudulently downplayed the drugs’ addictive qualities and negligently distributed unusually large quantities of the drugs.
The suits are part of a national wave of legal actions by local governments alleging manufacturers and distributors of prescription opioids are largely responsible for an epidemic of addiction that has caused thousands of deaths and strained public resources.
Ramsey County Attorney John Choi said some of the Minnesota lawsuits were filed this week, but more will follow in coming weeks and months.
Washington County Attorney Pete Orput called the crisis “a public nuisance” and said the suits are being filed because opioid manufacturers and distributors “need to help us clean it up.”
The drugs can be helpful for short-term use such as post-surgery or end-of-life care, Orput and others acknowledged. But they allege that in trying to expand demand, companies marketed the drugs to doctors to use for long-term care and chronic pain “knowing that doing that is going to cause a significant number of addictions,” Orput said.
The counties blame distributors for failing to detect and report large orders in certain areas, leading to drugs being used for nonmedical purposes.
Drug manufacturers who responded to Star Tribune inquiries on Thursday said they were committed to working toward a solution to opioid abuse. They also defended their practices with prescription drugs, saying when they are sold, prescribed and used responsibly, they can provide pain relief for patients.
Won’t be ‘scapegoats’
The Healthcare Distribution Alliance said in a statement that distributors understand the tragic impact of the opioid epidemic “but we aren’t willing to be scapegoats.”
Distributors transport medicine and don’t make, market, prescribe or dispense the drugs to consumers, the statement said. Pointing responsibility at them “defies common sense and lacks understanding of how the pharmaceutical supply chain actually works,” the statement said.
In voluminous separate federal lawsuits filed Thursday on behalf of Ramsey and Washington counties, attorneys from the Minneapolis law firm of Lockridge, Grindal, Nauen alleged nine legal causes of action, including creating a public nuisance, negligence, fraud, unlawful and deceptive trade practices and false statements in advertising. The suits seek to stop the companies from engaging in their unlawful practices and compensate the counties for “past harm and abatement of the nuisance.”
The suits are filed through private firms on a contingency basis, meaning the firms assume the cost of investigating and presenting the case, but then collect attorney’s fees out of any damage awards they might win.
Hennepin County and other governments are expected to file suit in the coming weeks and months.
Hennepin County Attorney Mike Freeman said at Thursday’s news conference that the lawsuits are part of a three-pronged approach to fighting the epidemic; the other strategies include prosecuting dealers on homicide charges and educating the public about the dangers of the drug.
Though attorneys had no official count of how many Minnesota counties and municipalities will sue, they said they expect a substantial number to do so. Some Minnesota counties and municipalities were aiming to file this week because of a federal hearing on such litigation held Thursday in Missouri.
In Minnesota, officials in St. Louis, Chisago, Mower and Steele counties indicated they would sue, as well as the cities of Minneapolis and St. Paul.
The lawsuits are being filed separately, and some may be filed in state court instead of federal court, attorneys said.
“Every county is going to have a different story to tell,” Choi said. “There’s going to be individualized allegations.”
St. Louis County Attorney Mark Rubin, who was at the news conference, said the crisis extends far beyond metropolitan areas and affects multiple generations. “Babies are being born addicted to these drugs,” he said.
Ramsey County Board of Commissioners Chairwoman Victoria Reinhardt, also speaking Thursday, said she knew two young men who lost their lives to opioid addiction despite trying very hard to shake it.
Companies are “walking away with a whole lot of money, and it’s at our expense,” Reinhardt said. “When medications are used correctly, there is good that can come of them, but that’s not what’s happening here, that’s not what we’re targeting.”
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Minnesota counties to sue opioid manufacturers
Nov 30, 2017 | Woodbury Bulletin
By Katie Nelson
Washington County, along with about 20 other Minnesota counties, announced civil action against major pharmaceutical companies Nov. 30 for the sale and manufacture of opioid drugs.
The counties will file separate lawsuits, but Washington County Attorney Pete Orput said they are all working in conjunction to launch the suits. Prosecutors say the lawsuits are a response to the rise in opioid abuse and an attempt to hold pharmaceutical companies responsible for their products and marketing.
"(There) will be more civil lawsuits to come as the weeks and month progress throughout the state of Minnesota around the issue of holding accountable the manufacturers and distributors of opiate pain medication for their role in what we are dealing with," Ramsey County Attorney John Choi said.
Orput said some of the suits will be filed in the state and others may be filed in federal court.
"Each of our suits are similar in that we've had enough of the fraudulent marketing and negligent distribution of opioids and all of us have been struggling with the devastating effects they have on our communities, and all of this has been done in the name of outrageous profits," he said.
The claim rests in part on what Orput called "fraudulent" marketing.
"(A manufacturer's) marketing claims must be supported by science, and that hasn't happened. The defendants broke those simple rules," Orput said.
"I don't want their money; I want the justice," Orput added. "But I'll take their money, because we have a huge problem and we need to fix it."
Services needed to treat the effects of opioids, including social and health and human services, used often rest in county control, which leads to significant costs to the county and taxpayers, official said.
"Washington County is just as much at risk as any other community," Washington County Board Chair Lisa Weik said.
There were 11 opioid overdose deaths in Washington County in 2016, and there have been 99 since 2000. Nearly 7 percent of Washington County students reported in the Minnesota Student Survey that they had used prescription drugs that were not prescribed to them in the last month.
Dakota County Commissioner Mike Slavik said the county seems to be moving in the direction of filing a complaint but they will vote on Dec. 12.
Slavik and Dakota County Attorney James Backstrom were at the news conference.
"It's an important issue that needs to be addressed," Backstrom said.
Washington County is suing manufacturing companies including Purdue Pharma,The Purdue Frederick Company, Teva Pharmaceutical, Cephalon, Johnson and Johnson, Janssen Pharmaceuticals, Ortho-McNeil-Janssen Pharmaceuticals, Noramco, Endo Pharmaceuticals, Allergan, Watson Pharmaceuticals, Actavis, Watson Laboratories and distributing companies Mallinckrodt, McKesson Corporation, Cardinal Health and AmerisourceBergen Drug Corporation.
"We must hold these corporate schlockmeisters responsible for their rapacious profiteering that has directly contributed to deaths, family break-ups, hospitalizations and addiction," Orput said. "The manufacturers and distributors caused this epidemic and we're asking that it stop."
Minnesota is not the only state to file against pharmaceutical companies that manufacture and distribute opioids, including several Wisconsin counties.
Washington County is using Minneapolis law firm Lockridge Grindal Nauen.
Michelle Wirth contributed to this story.
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Brown, Outagamie counties could join 48 counties' lawsuit against opioid drug-makers
Nov 30, 2017 | Green Bay Press-Gazette (WI)
By Doug Schneider
Brown and Outagamie counties could soon join a lawsuit against the makers of pain-killing opioid drugs, pushing the number of counties suing the companies to 50.
A Brown County committee voted 4-0 this week to recommend that Brown join the legal case filed in early November against several pharmaceutical drug-makers and physicians. The suits allege fraudulent marketing of prescription painkillers is causing a nationwide public-health crisis of opioid addiction and overdose deaths — 31,000 fatalities in a recent year.
"Our chances of success are pretty good," said David Hemery, Brown County's corporation counsel.
Outagamie County supervisors are expected in December to consider joining the case, county spokesman Larry Abitz said. Calumet, Manitowoc and 18 other counties joined the lawsuit this week.
In northeastern Wisconsin, Door, Oconto and Shawano counties were already part of the lawsuit.
Suits filed in U.S. district court in Milwaukee seek millions of dollars for the costs of social services, law enforcement and emergency care in responding to the opioid epidemic in each county. The companies created a public nuisance through deceptive marketing that misrepresents the safety of long-term opioid use, the lawsuits allege.
"County governments are bearing the brunt of the costs," said Erin Dickinson of Crueger Dickinson LLC, lead counsel along with partner Charles Crueger in the lawsuits filed this month. "Defendants must be held responsible for the devastating effects their actions have produced on counties across this country.”
Wisconsin has averaged more than 600 yearly opioid-related deaths in a three-year period, figures show. Milwaukee County, alone, has already had more than 300 such deaths this year.
The opioid lawsuit is similar to a case in which 46 states sued cigarette manufacturers, seeking to recover some of the billions of dollars in tobacco-related health-care costs incurred by those states and the people living in them. Four companies settled with the states in the 1990s, agreeing to pay the states more than $200 billion over a 25-year period and to cease certain marketing practices.
The opioid epidemic, particularly involving the abuse of heroin and its 50-times-stronger stronger cousin, fentanyl, hits communities in a range of ways. Who foots the bill? Taxpayers.
» Crime: Users often to turn to crime to get money to buy drugs. Brown County District Attorney David Lasee said drug issues fuel crimes ranging from burglaries and simple thefts to violent crimes like robberies.
In cases where an overdose kills someone, the DA's office will prosecute the person who provided the drugs. Such cases are now known as "Len Bias cases," after the former Maryland basketball star who fatally overdosed in 1986 on drugs provided by a friend, Brian Tribble; he would later be indicted on cocaine charges.
» Public safety: Drug issues place additional burdens on police and firefighters.
Police must devote time and effort tracking stolen goods that addicts have pawned for money. Firefighters and paramedics must be trained on and supplied with Narcan, the common name for a drug that can counteract a drug overdose.
» Courts: Drug cases often clog the system, as prosecutors with limited resources must sometimes choose between prosecuting drug cases and other crimes.
In recent years, Brown has hired additional prosecutors to help clear backlogged drug cases. While that can help in the short term, it's tax money that could be used for other things.
» Jails: A backlog of drug cases can crowd county jails.
Counties with limited space, like Brown, must send inmates to other counties — and pay to house them there. Brown County Executive Troy Streckenbach said his county's costs, while not all drug-related, could approach $1 million next year.
» Health care: Users require treatment not only when they overdose but tend to suffer higher instances of hepatitis C and other conditions. Additionally, hospitals and communities face increased pressure to provide drug-treatment and detoxification beds.
Wisconsin's opioid overdose deaths rose from 5.9 per 100,000 residents in 2006 to 10.7 per 100,000 residents in 2015, the Department of Public Health Services found. Opioid-related hospital visits in Wisconsin, which include inpatient hospitalizations and emergency department visits, have doubled in the past decade.
In the group of 28 counties that originally filed the suit, more than 320 people died from opioid overdoses between 2013 and 2015, according to the Milwaukee Journal Sentinel. The grim tally in Wisconsin reached 1,824 deaths in that period.
More than two dozen states, cities and counties around the U.S. have sued to hold pharmaceutical drug-makers and distributors accountable for bad faith business practices and misrepresentation in marketing of opioids.
In 2015, more than 31,000 U.S. residents died from opioid overdoses, according to the Centers for Disease Control and Prevention.
he Journal Sentinel contributed to this story.Who's being sued
The defendants: Purdue Pharma L.P.; Purdue Pharma Inc.; The Purdue Frederick Co. Inc.; Teva Pharmaceuticals USA Inc.; Cephalon Inc.; Johnson & Johnson; Janssen Pharmaceuticals Inc.; Ortho-McNeil-Janssen Pharmaceuticals Inc.; Janssen Pharmaceutica Inc.; Endo Health Solutions Inc.; Endo Pharmaceuticals Inc.; and physicians Perry Fine of Utah, Scott Fishman of California and Lynn Webster of Utah.
The physicians allegedly were "instrumental in promoting opioids for sale and distribution nationally," and in Wisconsin, according to the lawsuits.
Purdue Pharma makes OxyContin and Dilaudid. Endo Pharmaceuticals makes Percocet and Percodan. Janssen Pharmaceuticals makes a fentanyl skin patch. Cephalon makes a fentanyl lozenge.
— USA TODAY Network-Wisconsin
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More Wisconsin counties join suit against big pharmaceutical companies
Dec 1, 2017 | News8000.com (WI)
By Mal Meyer
Twenty more Wisconsin counties have filed lawsuits against big pharmaceutical companies alleging that the businesses engaged in deceptive marketing campaigns to push their products. The counties are asking for money from the companies to pay for an increase in services provided due to the opioid epidemic.
Two-thirds of all counties in Wisconsin have now filed lawsuits against Purdue Pharma, Johnson and Johnson, Endo Health Solutions and their subsidiaries. The movement to file suits against the pharmaceutical companies started just a few months ago at a Wisconsin Counties Association convention.
"We heard about it but it wasn't something clear to us at that point. It became very clear what was being proposed at the convention," said Sally Miller, the Trempealeau County board member representing District 3.
From there, the representatives went back to their county board committees with details about how they could join suit in order to receive money for additional opioid epidemic response services.
"There's been a substantial increase in need for services in terms of consultations, training and hospitalization," said Jim Bialecki, administrator for Monroe County.
In Trempealeau County, they too have see the affect on law enforcement, the health department and human services.
"There's very few departments in the county that aren't being strained by responding," Miller said.
The counties are working with two law firms based in New York and Milwaukee and are asking for an unspecified amount of money.
"There would be a portion back that would be a direct payback to local governments versus the state keeping everything," Bialecki said.
For Miller, this isn't just a financial question but a moral one.
"My position as an elected official has always been that it is my job to be a voice for the people that don't have a voice," Miller said.
They're hoping that if more individual counties could come together to speak out, they'd be more successful that just the one state calling for damages.
"Wisconsin and their counties are not the only ones involved. This is going to be a nation wide effort," Bialecki said.
While La Crosse County has not yet filed a lawsuit as well, Administrator Steve O'Malley said it will be discussed during an executive committee meeting on Dec.13th.
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Purdue Pharma Discloses Negotiations With AGs on Opioids
Nov 30, 2017 | Bloomberg
By Jef Feeley and Jared S. Hopkins
Purdue Pharma LP acknowledged in a letter that the maker of the opioid painkiller Oxycontin is in “negotiations’’ with state attorneys general over lawsuits accusing the company of creating a public-health crisis with its mishandling of the drug.
Maria Barton, Purdue’s general counsel, chastised Ohio Attorney General Mike DeWine for pulling out of a multistate probe of the drugmaker by 41 of his fellow attorneys general. He did so shortly after signing an agreement to preserve his state’s legal claims “while the investigation and negotiations were conducted,’’ according to a copy of the Nov. 28 letter provided by Purdue officials.
Barton’s letter is the first time an opioid maker has disclosed negotiations with state attorneys general who are seeking a big tobacco-style multibillion-dollar payout to cover the costs of burgeoning drug epidemics in their states.
Robert Josephson, a Purdue spokesman, declined to comment on whether the Stamford, Connecticut-based drugmaker is in settlement talks with the attorneys general. Bloomberg News reported on Nov. 17 that the company’s lawyers had been floating proposals for a global settlement of all opioid claims against Purdue and other drugmakers including Johnson & Johnson, Endo international Plc and Teva Pharmaceutical Industries.
Connecticut Attorney General George Jepsen, one of the leaders of the multistate probe, declined to comment on the letter Thursday because he said he hadn’t read it.
Separately, Endo officials have accused DeWine of wrongly accusing opioid makers of doing nothing to help address addiction problems caused by their products and making “offensive’’ claims that pharma companies had laid waste to his state.
“Your letter’s assertion that the pharmaceutical industry caused this epidemic is – at best – a stunning oversimplification,’’ Matthew Maletta, the company’s chief legal officer, wrote in a Nov. 28 letter.
Dan Tierney, a spokesman for DeWine, said Thursday Ohio’s top legal official isn’t “commenting on any of the letters we’ve received in response to the Attorney General’s demand letter.’’
Purdue’s and Endo’s letters came in response to an Oct. 30 missive DeWine sent to makers and distributors of opioid painkillers demanding they begin settlement talks within 30 days. DeWine, a Republican who is running for governor, sent the letter as part of a plan to combat opioid abuse in his drug-ravaged state.Drug Overdoses
More than 60,000 people died in the U.S. from overdoses in 2016, and there was a five-fold increase in such deaths involving synthetic opioids -- from 3,105 in 2013 to about 20,000 in 2016, according to federal researchers.
A study in the October 2016 issue of Medical Care Journal put the economic cost of opioid overdose, abuse and dependence at $78.5 billion. Health care accounts for about one-third of the cost, while lost productivity in nonfatal cases add another $20 billion, according to the journal published by Wolters Kluwer.
The Centers for Disease Control and Prevention has reported that 145 Americans die daily from opioid overdoses. The epidemic cost the American economy $504 billion in 2015, which was the equivalent of 2.8 percent of gross domestic product that year, according to a report this month by the Council of Economic Advisers.
In Purdue’s letter, Barton thanked DeWine for inviting the company to help address addiction problems in Ohio. “As you know, we have been working on an expedited basis with more than 30 state attorneys general as part of a bipartisan multistate process to resolve serious issues,’’ Barton said.Outside Lawyers
Barton urged DeWine to rejoin the multistate investigation by his fellow attorneys general so the state wouldn’t have to share any recovery with outside plaintiff lawyers it hired to press its case.
“It is uncontroversial that the multistate process is the best and fastest way for states to get resources to address this crisis,’’ Barton wrote.
While the companies jousted with DeWine, they also asked a panel of federal judges in St. Louis Thursday to gather all opioid suits in one federal court.
Purdue, Johnson & Johnson and some lawyers for cities and counties that have sued want the more than 60 lawsuits filed so far in federal courts across the country to be combined for information exchanges and test trials. The consolidation is intended to save money by avoiding duplication.
U.S. District Judge Sarah Vance of Louisiana, a member of the five-judge panel, warned lawyers for states and local governments that they’d face “serious’’ legal hurdles that could derail their bid for a multibillion-dollar payout.
“There are serious threshold issues when it comes to whether these governmental entities can sue for these damages,’’ Vance told lawyers arguing the cases should be consolidated in federal courts in West Virginia, Ohio or Illinois.
“The nation is watching what we do with these cases,’’ Roland Tellis, a lawyer representing governmental entities, told the panel. The judges didn’t immediately decide where the cases will be heard.
The case is In Re: National Prescription Opioid Litigation, MDL NO. 2804, Before the U.S. Judicial Panel on Multidistrict Litigation (St. Louis).
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JPML Open To Opioid MDL Despite Concerns About Size
Dec 1, 2017 | Law360
By Diana Novak Jones
The Judicial Panel on Multidistrict Litigation seemed to lean toward centralizing litigation stemming from the country’s opioid crisis during arguments at the panel’s hearing in St. Louis on Thursday, but the judges repeatedly asked for guidance on how to work with the large variety of potential defendants and plaintiffs.
The panel heard from more than 15 attorneys on the question of whether to create a multidistrict litigation covering lawsuits accusing the makers, distributors, dispensers and prescribers of opiate pain medication of creating a tsunami of overuse and addiction. While several judges said the cases had clear parallels, the panel had serious questions about whether the MDL would include all cases under the opioid umbrella or if it would need to be restricted to one group.
The panel took up the case at the request of a group of cities and counties who have sued the drugs’ manufacturers and distributors. The group asked that an MDL be sent to the United States District Court for the Southern District of Ohio or the United States District Court for the Southern District of Illinois, with supporters arguing those courts are closest to the epicenter of the problem.
The majority of the cases filed so far — 155 in 25 districts across the country — involve the claims of government entities, said Roland K. Tellis of Baron & Budd PC, who represents the city of Cincinnati and spoke on behalf of the group. The heart of their claims come from a duty to report and stop suspicious transactions in the sale of opiates, Tellis said, so any case that turns on that duty should be included.
“We get that there’s a common issue,” U.S. District Court Judge R. David Proctor told Tellis, adding that the real question comes as the litigation progresses and a wider variety of cases are brought. Adding them to an MDL could “make this a tangled web that’s very difficult to manage,” Judge Proctor said.
U.S. District Judge Charles Breyer suggested that a single MDL could be created to manage discovery on the cases’ common issues, and then the panel could be called on to create separate MDLs for the different cases down the road.
Or U.S. District Judge Catherine Perry offered that plaintiffs could ask for remand to state court after they get common discovery.
Beyond the group of municipalities, the three major distributors and the manufacturers support centralization, albeit in different courts.
Enu Mainigi of Williams & Connolly LLP, who represents the distributors, told the panel the judge overseeing the MDL could decide how to handle claims involving third-party payors, prescribers and others. But “we cannot have 150 different rulings on these issues,” she said.
Manufacturers Purdue Frederick Company Inc., Janssen Pharmaceuticals Inc. and others urged the panel to send the case to federal court in Chicago, where the first case against the opioid manufacturers was filed by the city.
But Chicago asked the panel to leave them out of any MDL, as the city’s case is well into discovery and would have to take several steps backward should it be lumped in with the others.
Issues that have been “painfully negotiated” would have to be revisited, said counsel for Chicago, Linda Singer of Motley Rice LLC.
Singer and several other attorneys for municipalities told the panel an MDL would inevitably slow down their ability to fight a problem that continues to take lives.
Christopher Huck of Kelley Goldfarb Huck Roth & Riojas PLLC, who represents the town of Everett, Washington, pointed out the JPML has never been in favor of using MDLs to centralize litigation against an industry as a whole.
This is bigger, Huck said, as it involves the makers, distributors, prescribers and more for 12 different drugs.
“This is not the case to test these waters,” Huck said. “People are dying every day.”
U.S. Circuit Judge Marjorie Rendell and U.S. District Judges R. David Proctor, Charles Breyer, Sarah Vance and Catherine Perry sat on the panel.
The case is In Re: National Prescription Opiate Litigation, MDL No. 2804. -
County suing companies that make, distribute opioids
Dec 1, 2017 | News-Press Now (MO)
By Marshall White
Buchanan County commissioners are taking action to address the local public health crisis known as the “opioid epidemic.”
The commission unanimously voted to file a federal lawsuit Wednesday “to recoup taxpayer monies that have been spent because of defendants’ false, deceptive and unfair marketing and/or unlawful diversion and distribution of prescription opioids.”
“The opioid crisis affects individuals, children, families, businesses, law enforcement, social services and the medical community,” said Harry Roberts, Buchanan County presiding commissioner. “The goal is to totally eradicate the sale of illegal drugs in Buchanan County.”
Roberts told News-Press Now he learned about the possibility of a lawsuit several weeks ago. Then he checked out the Wagstaff & Cartmell LLP law firm in Kansas City.
They have experience in dealing with these large drug companies, Roberts said, and they accepted the county as client on a contingency basis.
The county is suing 22 companies for manufacturing and/or distributing opioids across the United States, including Johnson & Johnson.
The responsibility for the epidemic starts with the companies that have profited the most from it, said Scott Burnham, the Eastern District commissioner.
“The conduct of these companies has helped the epidemic take root and grow into a full-blown crisis,” Burnham said.
While the lawsuit doesn’t specify any amount of damages, it’s talking about an industry involved in billions of dollars each year.
Three of the companies named control a large portion of the OxyContin market. The lawsuit states that since 2009, Purdue Pharma and affiliated companies have annual nationwide sales of OxyContin that fluctuated between $2.47 billion and $2.99 billion.
The lawsuit states OxyContin is roughly 30 percent of the entire market for analgesic drugs or painkillers.
The lawsuit has named three wholesale distributors, Amerisource Bergen Drug Corp., Cardinal Health and McKesson Corp., as the companies dominating 85 percent of the market for the distribution of prescription opioids.
Those three companies plus Pardue are four named as violators of the Racketer Influenced and Corrupt Organization Act or RICO. The lawsuit alleges these four companies engaged in mail and wire fraud.
The commissioners seek a temporary or permanent injunction for engaging in unfair or deceptive practices. The county commissioners want compensation for past and future costs to abate the ongoing public opioid nuisance and for creation of a fund for abating the opioid nuisance.
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County could sue drug companies over opioids
Dec 1, 2017 | The Record Delta (WV)
By Katie Kuba
Who’s to blame for the opioid epidemic devastating the Mountain State — drug distributors that manufacture and market the painkillers on which so many West Virginia residents have gotten hooked or the doctors who prescribe them?
Those questions — and the answer — may be central to the Upshur County Commission’s decision on whether it will pursue litigation against pharmaceutical companies that have been accused of shipping large amounts of prescription opioid drugs into the state and failing to disclose just how addictive they are.
At Thursday’s weekly commission meeting, commissioners unanimously voted to explore filing a lawsuit against prescription drug manufacturers — at least preliminarily.
Commissioner Troy “Buddy” Brady made a motion that the commission direct county administrator Carrie Wallace to advertise for proposals from law firms pursuing suits against prescription drug manufacturers.
“I’m not much for suing, but with that being said, I think we need to keep our options open, and I think we need to see what’s out there, and if we’re going to do something, we should do it sooner rather than later,” Brady said. “I still hold that you can’t get the drug unless the doctor prescribes it.”
The discussion got under way when Wallace reminded commissioners that they had tabled the issue at their regular April 27 meeting, following a special joint meeting with the Lewis County Commission in the Lewis County Courthouse on April 25. At the special meeting, representatives from two law firms — Alan Pritt of Pritt & Spano in Charleston and Rusty Webb of the Webb Law Centre in Charleston — presented information to commissioners from both counties about the particulars of suing companies that have allegedly flooded the state with opioid prescription painkillers.
The purpose of the suit, the attorneys said at the time, would be to recover the money the drug epidemic has cost counties – in the form of increased county jail bills, increased E911 calls, decreased tourism and difficulties employers have with filling available jobs. West Virginia’s opioid overdose death rate — 36 percent — was the highest in the country in 2015, according to statistics from the Kaiser Family Foundation.
Commissioners tabled the decision about whether to move forward on April 27 and haven’t discussed it since, Wallace said at Thursday’s meeting.
“There hasn’t been discussion regarding this topic since then, and we know a panel of judges will soon decide whether to consolidate dozens of these lawsuits filed across West Virginia and in other states,” Wallace said. “So, I would recommend, at this point, if you do want to file a lawsuit, you probably do so sooner rather than later and start looking for options as far as attorneys go. If you’re going to do something, now is the time rather than waiting any longer.”
Commissioner Sam Nolte suggested the commission at least advertise for proposals from attorneys.
“I think we should probably advertise and then boil it down to maybe two or three and then just hear their presentation again just to see where they’re at … and if we’re going to move forward, we can make the decision from there,” Nolte said.
Nolte suggested the commission notify the firms they’d already heard from and advertise for proposals from additional firms.
Brady made a motion to advertise for proposals prior to making a decision.
“I move that we check our options and see what our choices are down the road and then make our final decision,” Brady said. Nolte seconded the motion, which passed unanimously.
Upshur County put out a request for information on a countywide list, and of the 16 counties that responded to the request, 14 had opted to sue drug companies, according to Wallace. Law firms listed multiple times included Greene, Ketchum, Bailey and Tweel Law Firm in Huntington; Skinner Law Firm in Charles Town; and Fitzsimmons Law Firm in Wheeling. At the April 25 special meeting, both Webb and Pritt said their respective firms would charge 25 percent of the amount of money awarded, with the Webb firm also charging a filing fee and Pritt & Spano charging a filing fee plus a service of process fee.
In other news, the commission also:
-Approved a request from Adrian PSD manager Nina Monroe for the reappointment of Paul A. Spencer to the Adrian PSD Board of Directors, effective immediately. His term will expire Oct. 31, 2023.
-Approved a request from Kathy McMurray, president of the Upshur County Development Authority, to appoint West Virginia Wesleyan College president Joel Thierstein to the UCDA Board. Thierstein’s term will begin on Jan. 1, 2018 and expire on June 30, 2021.
-Approved the reappointment of Ervin Lake to the James W. Curry Library and Park Advisory Board. His term will expire Dec. 31, 2022.
-Approved a request from Laura Meadows, executive director of the Upshur County Convention and Visitors Bureau to donate 10 pool passes for the Buckhannon Readiness Center’s 601st Engineering Support Company’s Christmas Party.
-Approved Lewis-Upshur County Animal Control Facility volunteer Keisha George.
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Some counties joining lawsuits against drug companies
Nov 30, 2017 | The Effingham Daily News (IL)
By Graham Milldrum
Americans die of opioid overdoses at a rate of 91 per day.
Local communities are casting about for tools to protect their citizens. One that has increased in popularity is suing the companies responsible for producing and distributing opioid medications.
Effingham County Board members reported they have been contacted by attorneys who are interested in suing the companies involved on the county's behalf. One of those attorneys, Tom Lech from Goldenberg, Heller and Antognoli, spoke at a recent county board meeting.
Effingham County State's Attorney Bryan Kibler said he has the authority to pursue these on the county's behalf, but he wanted the board to be involved. Board members Rob Arnold and David Campbell said in interviews that they lack sufficient information to come to a decision.
"Until I can hear all or at least most of the options, I won’t commit one way or the other. Not sure what options we have," Arnold said.
Board Member John Perry is firmly against it.
A for-profit company needs to look at ways to expand its markets, he said. If the company or its employees have acted illegally, there are already criminal prosecutions available, Perry said.
"Why aren't they going after the drug dealers? I'll tell you. It's because they don't have billions," Perry said.
Lech was asked how much the firm stood to gain from the decision. He said attorneys would receive a third of the settlement. They are suing on a contingency basis, meaning the county only pays if there is a settlement.
Perry said this sort of litigation would only support the anti-business image of Illinois and would lead to higher costs for those in need of medication.
"It's a solution for a problem we may or may not even have," Perry said.
Lech said they would need experts to evaluate what the actual cost to Effingham County was in the case.
The firms involved have been filing in federal court, rather than in county courts. Lech said that was to use the greater power of federal subpoenas in their research.
A similar case is active in St. Clair County, where the county sued Purdue Pharma and Abbott Laboratories for their involvement in the opioid crisis.
"A pharmaceutical manufacturer should never place its desire for profits above the health and well-being of its customers. Drug manufacturers have a legal duty to ensure their products are accompanied by full and accurate instructions and warnings to guide prescribing doctors and other health care providers in making treatment decisions. They must tell the truth when marketing their drugs and ensure that their marketing claims are supported by science and medical evidence. Defendants broke these simple rules," the county wrote in its filing.
The case alleges the companies were engaged in deceptive practices by lying about effects of opioids, deceptive practices by targeting vulnerable populations with untrue marketing, civil conspiracy by secretly spending money to influence doctors, and unjust enrichment by the overprescription of drugs.
The Attorney General's Office has undertaken a number of efforts as well. One was a $4.45 million settlement with Insys Therapeutics Inc., a case settled on Aug. 18, 2017. In that case, Insys was selling Susbys, a fentanyl-based drug intended to manage breakthrough pain in cancer patients tolerant to painkillers, for uses not approved by the FDA.
“Insys pushed a highly addictive opioid in complete disregard for patients’ health to increase company profits,” Attorney General Lisa Madigan said in a press release announcing the decision. “It’s unethical, greedy behavior by companies like Insys that is responsible for creating the opioid epidemic and resulting overdose deaths in our state.”
As part of the settlement, Insys was ordered to cut back on promotional efforts, including the number of speaker programs and direct communication with patients.
The AG's office has also joined a 41-state coalition that is investigating the sale of these drugs.
"The attorneys general served investigative subpoenas to pharmaceutical companies, including Endo, Janssen, Teva/Cephalon, Allergan and their related entities. The attorneys general also served a supplemental subpoena on Purdue Pharma. In addition to the subpoenas, the attorneys general sent letters to opioid distributors AmerisourceBergen, Cardinal Health and McKesson requesting documents detailing their opioid distribution businesses," according to a press release announcing the investigation.
The board has not scheduled any formal action on the request.
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Opioid manufacturers face first-of-its kind lawsuit from Mississippi hospital
Nov 30, 2017 | Clarion Ledger (MS)
By Anna Wolfe
Like it did against Big Tobacco in the 1990s, Mississippi is helping lead the fight against opioid manufacturers amid an epidemic killing nearly 100 Americans each day.
On Thursday, Southwest Mississippi Regional Medical Center in McComb and two Alabama hospitals filed suit against several opioid manufacturers, claiming the companies deceptively marketed and sold the drug. Attorneys filed the first-of-its-kind lawsuit in federal court in Jackson.
The 135-page lawsuit details how Purdue Pharma — manufacturer of OxyContin, the pill receiving the most claims of mismarketing — Johnson & Johnson, Teva Pharmaceutical Industries, Endo Pharmaceuticals and others allegedly "pushed highly addictive, dangerous opioids, falsely representing to doctors that patients would only rarely succumb to drug addiction."
As a result, hospitals have had to treat patients for opioid addiction and overdoses and babies born with opioid addiction. The treatment is "intensive, complex and lengthy" and often uncompensated.
The hospitals claim these monetary losses as damages, alleging they never would have had contact with these patients, and the patients would not have opioid conditions, "but for the opioid epidemic created and engineered by Defendants."
For an idea of the issue in rural southwest Mississippi, consider this: Norman Price, CEO of Southwest Mississippi Regional Medical Center, recently received two phone calls in the middle of the same night from different parents in a rural area outside McComb. They both called as they watched their children experience heroin withdrawals, wondering what to do.
In the McComb area, "you can't get a headache without somebody knowing about it," and because Price is the hospital CEO and listed in the phone book, he gets the calls.
"It's here. It's not only in the city; it's here," Price said. "I hear it on my phone at 3 a.m. in the morning when a frantic mother calls me wanting help with a child going through heroin withdrawals."
The medical center does not have a drug addiction unit, but it has seen an uptick in patients with opioid-related issues frequenting the emergency department, sometimes carrying over into the intensive care unit.
"The most expensive resources in a health care facility are being directed towards an abuse of a drug which affects the hospital," Price said. "Many times when people are addicted or abusing the medication, they don't have the means to pay their bill. What happens is you have this large drain on resources that's a result of this."
Purdue said in a statement it denies the lawsuit's allegations and that the company is working to solve the opioid public health crisis. Teva said in a statement it provides resources to doctors, pharmacists and patients about responsible pain management and is working to develop non-opioid chronic pain treatment.
A representative from Janssen Pharmaceuticals, a Johnson & Johnson company, said the lawsuits are "legally and factually unfounded" and that the company has acted in the best interest of patients, including warning labels on each product.
Endo also denied the allegations and said it has ceased opioid promotion.
Don Barrett, the Lexington attorney who worked on the tobacco lawsuits that yielded billions in damages for the state, is representing Southwest Mississippi Regional Medical Center.
During the Tobacco Wars of the 1990s, America's hospitals did not get involved in litigation, though Barrett calls them "the institutions most directly damaged."
"I know because I was in that fight," he wrote in an email. "Hospitals are the front-line troops in the opioid battle. Hospitals have lost billions treating opioid-related medical problems. Yet they have been thus far ignored. America's hospitals will be ignored no longer."
Barrett said his is the first opioid lawsuit of it's kind — a class action, RICO lawsuit — from a hospital. Southwest joined with Infirmary Health Hospitals and Monroe County Hospital, both in Alabama, on the suit.
RICO stands for the Racketeer Influenced and Corrupt Organizations Act, which allows for criminal and civil penalties against criminal organizations guilty of racketeering. These are powerful but difficult to prove cases.
Because it is a class action lawsuit, it represents all U.S. hospitals who have treated patients with opioid-related health issues.
Southwest is adding to the pile of existing litigation against these pharmaceutical companies. Mississippi Attorney General Jim Hood filed a similar suit in 2015.
he hospital's case against the pharmaceutical companies narrows in on the use of opioids for chronic pain, which was generally discouraged or prohibited prior to 1990.
"Each Manufacturer Defendant has conducted, and has continued to conduct, a marketing scheme designed to persuade doctors and patients that opioids can and should be used for chronic pain, resulting in opioid treatment for a far broader group of patients who are much more likely to become addicted and suffer other adverse effects from the long-term use of opioids," the lawsuit states. "In connection with this scheme, each Manufacturer Defendant spent, and continues to spend, millions of dollars on promotional activities and materials that falsely deny or trivialize the risks of opioids while overstating the benefits of using them for chronic pain."
Dr. Charles Miles, president of the Mississippi Board of Medical Licensure, which is working to alter opioid prescription guidelines in the state, told the Clarion Ledger chronic pain is going to be a challenge in fixing the painkiller climate.
"The one that's going to cause problems is the methadone for chronic pain," Miles said. "We would just like for that to be stopped."
There's no reason opioids can't be used for short-term, acute pain, Miles said, but for chronic pain, there's no advantage to using opioids versus non-opioid medication therapy.
The likeliness of a person using opioids a year after receiving a prescription increases based on the length of the prescription, from 13.5 percent after a week to 30 percent after a month.
The state is in a record-setting year for drug overdose deaths. So far in 2017, at least 220 Mississippians have died from overdoses, mostly from opioids, whether legal prescriptions or illegal forms like heroin.
"The opioid epidemic did not happen by accident," the lawsuit alleges. "These pharmaceutical companies aggressively advertised to and persuaded doctors to prescribe highly addictive, dangerous opioids, and turned patients into drug addicts for their own corporate profit. Such actions were unlawful."
Contact Anna Wolfe at 601-961-7326 or awolfe@gannett.com. Follow her on Twitter.
Statements from pharmaceutical companies:
We are deeply troubled by the opioid crisis and we are dedicated to being part of the solution. As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge. Although our products account for approximately 2% of the total opioid prescriptions, as a company, we’ve distributed the CDC Guideline for Prescribing Opioids for Chronic Pain, developed three of the first four FDA-approved opioid medications with abuse-deterrent properties and partner with law enforcement to ensure access to naloxone. We vigorously deny these allegations and look forward to the opportunity to present our defense.
—Purdue Pharma
Teva is committed to the appropriate use of opioid medicines, and we recognize the critical public health issues impacting communities across the U.S. as a result of illegal drug use as well as the misuse and abuse of opioids that are available legally by prescription. To that end, we take a multi-faceted approach to this complex issue; we work to educate communities and healthcare providers on appropriate medicine use and prescribing, we comply closely with all relevant federal and state regulations regarding these medicines, and, through our R&D pipeline, we are developing non-opioid treatments that have the potential to bring relief to patients in chronic pain. Teva offers extensive resources for prescribers, patients and pharmacists regarding the responsible pain management and prevention of prescription drug abuse. Teva also collaborates closely with other stakeholders, including providers and prescribers, regulators, public health officials and patient advocates, to understand how to prevent prescription drug abuse without sacrificing patients’ needed access to pain medicine.
—Teva Pharmaceutical Industries
Responsibly used opioid-based pain medicines give doctors and patients important choices to help manage the debilitating effects of chronic pain. At the same time, we recognize opioid abuse and addiction is a serious public health issue that must be addressed. We believe the allegations in lawsuits against our company are both legally and factually unfounded. Janssen has acted in the best interests of patients and physicians with regard to its opioid pain medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label. According to independent surveillance data, Janssen opioid pain medicines consistently have some of the lowest rates of abuse among these medications, and since 2008 the volume of Janssen opioid products always has amounted to less than one percent of the total prescriptions written per year for opioid medications, including generics. Addressing opioid abuse will require collaboration among many stakeholders and we will continue to work with federal, state and local officials to support solutions.
—William Foster, spokesperson, Janssen Pharmaceuticals, Inc. (Johnson & Johnson)
Endo is dedicated to providing safe, quality products to patients in need and we share the public concern regarding opioid abuse and misuse. We are committed to working collaboratively to develop and implement a comprehensive solution to the opioid crisis, which is a complex problem with several causes that are difficult to disentangle. Any serious solution must therefore be multifaceted and consider, among other things, the legitimate access needs of the millions of patients suffering from acute or chronic pain who rely on opioids to improve their quality of life.
Toward that goal, Endo has taken meaningful action during the past year by voluntarily ceasing opioid promotion and eliminating its entire product salesforce. Endo also voluntarily withdrew Opana® ER from the market following FDA's request despite having a statutory right to challenge that request, implemented additional anti-diversion measures and terminated its new opioid product development programs.
It is Endo's policy not to comment on current litigation. That said, we deny the allegations contained in this lawsuit and intend to vigorously defend the Company.
—Endo
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Local hospitals involved in lawsuit against opioid distributors and manufacturers
Dec 1, 2017 | WPMI NBC 15 (AL)
By Staff
A class action lawsuit has been filed to shift the cost of the opioid crisis from hospitals to those it alleges are responsible- several of the leading opioid distributors and manufacturers in the country. The suit is filed on behalf of two area hospitals and an area medical group.
The suit alleges the manufacturers and distributors of opioids misrepresented the safety of the drugs in marketing and advertising, and that the manufacturers misrepresented how addictive the drugs could be.
According to the suit, pharmaceutical companies aggressively and unlawfully pushed doctors to prescribe the drugs, turning patients into addicts for corporate profit.
The lawsuit also alleges that the wholesale distributors of the drugs unlawfully violated their responsibilities under federal law to monitor, detect, investigate, refuse to ship and report suspicious orders of prescription opiates. As a result of this conduct, the suit alleges, hospitals have sustained substantial financial losses.
As this class action lawsuit grows, it has the potential to rival the big tobacco lawsuit or those against the mortgage industry.
This story is just breaking tonight and our investigators are working to bring you new information about the scope of the lawsuit and how it will impact people in Mobile.
We'll bring you much more tomorrow only here on NBC 15.
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County readies to sue opioid makers
Dec 1, 2017 | The Chronicle-Telegram (OH)
By Scott Mahoney
The Lorain County commissioners are joining the growing number of municipalities that are suing the manufacturers and distributors of prescription opiates.
On Wednesday, the commissioners voted in favor of hiring Napoli Shkolnik, a law firm based in New York City, as outside counsel to represent the county.
“The opioid epidemic has hit this county hard,” Commissioner Matt Lundy said. “Throughout the past couple months, a lot of counties and cities have moved forward to enter into litigation against the manufacturers and distributors.”
On Tuesday, the city of Elyria filed a lawsuit alleging the practices of big drug companies rose to the level of racketeering with pharmaceutical manufacturers and distributors working in concert to engage in a pattern of corrupt activity. The city of Lorain filed a similar suit earlier in the year.
Lundy said the situation is similar to when “members of the tobacco industry sat in front of Congress, under oath, and said nicotine was not addictive.” The manufacturers were misleading in their representation, misrepresenting the addiction risk and deceptively presenting the risks and benefits of opioids in a manner that made them look safer than they are, according to Lundy.
The Lorain County Prosecutor’s Office had to sign off on the decision to hire outside counsel and were instrumental in picking Napoli Shkolnik, Lundy said.
“The Prosecutor’s Office is our legal counsel, so we can’t just hire any firm to represent us,” he said. “I give the prosecutor (Dennis Will) a lot of credit. He went through these letters we received (from various law firms around the country offering to represent the county), looked at what they were proposing and this was the firm they were comfortable with.”
While Napoli Shkolnik is based in New York, the firm has partnered with local lawyer who practices statewide in Ohio and in Lorain County — Frank Gallucci, whose office is in Cleveland. Gallucci will be the point man for any civil action taken against the manufacturers and distributors, Lundy said.
Napoli Shkolnik represents more than 40 municipalities across the nation in litigation against opioid manufacturers and distributors. It has filed lawsuits on behalf of the cities of Lorain, Parma and Dayton and Cuyahoga County.
A lawsuit on behalf of Lorain County hasn’t been filed yet, but hiring Napoli Shkolnik is the first step in the process, Lundy said.
“Obviously, the opioid crisis has put a tremendous strain on the Prosecutor’s Office, Sheriff’s Office and Coroner’s Office,” Lundy said. “We want accountability, and that’s why we’re taking this action.”
The litigation will not cost the county any money, Lundy said.
“We’re not having to pay expenses or fees,” he said. “All of that comes out of the settlement. It doesn’t cost us either way. The only way they get paid is if they win the case.”
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Mt. Lebanon forum features attorney general addressing opioid crisis
Nov 30, 2017 | The Almanac (PA)
By Harry Funk
As Pennsylvania’s top law enforcement official, Attorney General Josh Shapiro makes it a priority to tackle what he believes to be the state’s No. 1 public safety and public health threat: the heroin opioid epidemic.
“My job is to go out and, in addressing this crisis, arrest people,” he said.
Since mid-January, his office had racked up 1,399 arrests of drug dealers – that’s 4.4 per day – as of Nov. 29, when he spoke at a substance abuse forum organized by state Rep. Dan Miller, D-Mt. Lebanon.
“I believe that’s just part of the supply chain,” Shapiro contended. “Why? Because four out of every five people who approach that drug dealer on the street corner to buy heroin started down their path of addiction by taking a legal prescription drug, by taking an OxyContin or a Percocet.
“So why, then, if we’re looking to solve this epidemic, aren’t we bringing in the pharmaceutical companies into that equation?” he continued, drawing a round of applause from his audience at St. Paul’s Episcopal Church in Mt. Lebanon. “That was one of the first questions I asked when I took office. And today, Pennsylvania is one of five lead states in the 41-state investigation into the opioid manufacturers and distributors here and across the United States.”
The attorney general joined Miller and state Sen. Guy Reschenthaler, R-Jefferson Hills, in opening the “Challenges to Recovery” forum by outlining efforts that Pennsylvania’s elected officials are making toward mitigating a trend that claimed more than 64,000 American lives in 2016 alone.
Shapiro said his office also has seen a 50 percent increase in diversion arrests, in cases where legal prescription drugs are diverted for illegal purposes, and has helped shutdown supply pipelines, including one from New York City to Altoona that “dumped 1.5 million bags of heroin in our communities.”
“Yet it may surprise you to know that I fundamentally believe you simply can’t arrest your way out of this crisis,” he said. “I approach the job every day understanding that drug addiction is a disease, not a crime.
“Yes, we have to go lock up the dealers. We have to lock up those who are peddling poison, making our communities less safe, putting our communities at risk. We do that. We’ve also got to make sure that treatment is a part of the solution.”
Toward that goal, Shapiro is among 39 state attorneys general in a bipartisan coalition calling for Congress to address a problematic facet of a 52-year-old piece of legislation: the Institutions for Mental Diseases exclusion, which prohibits the use of federal Medicaid financing for care provided to most patients in mental health and substance abuse disorder treatment facilities larger than 16 beds.
The coalition’s proposed Road to Recovery Act would remove the exclusion for addiction treatment facilities only.
Regarding the diversion of legal drugs, Shapiro said efforts are in place to provide continuing education for medical practitioners to encourage the prescribing of fewer opioids and for shorter durations.
“Many of them are not breaking the law,” he said, “but their practices are things that are dangerous when it comes to fueling this crisis.”
Shapiro also has challenged health insurers to step up efforts in paying for addiction treatment services while taking steps such as authorizing opioid prescriptions for briefer periods.
The forum also featured a series of sessions with more than a dozen panelists in the legal, medical, human services and drug addiction recovery fields providing insight to various facets of substance abuse.
Miller said he organized the event as a follow-up to local town hall meetings addressing the crisis.
“What we came out of them often with were a variety of questions that just were too specific to be addressed at that time,” he explained. “That’s why we said, ‘We’ve got to develop something deeper,’ and that’s why we went out with the idea of creating dialogue sessions on each one.”
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Nov 30, 2017 | BuzzFeed News
By Dan Vergano
After the six-hour drive to the Lake Erie beach, Paul stood in the water and began walking into the waves.
The 53-year-old had been in intense pain for seven years, ever since a failed hernia surgery. That morning it had been so bad he couldn’t put on his underwear, only shorts and a shirt.
A passerby on the beach asked him if he was okay. And he remembered he hadn't said goodbye to his wife.
So he went home to tell her that he didn't want to live anymore.
Paul is one of some 2 to 6 million chronic pain patients in the United States who are prescribed extremely high doses of opioid painkillers like Vicodin, Percocet, and OxyContin. In the midst of a growing opioid epidemic, medical authorities say that’s far too many.
Last year, the CDC issued sweeping new guidelines encouraging doctors to stop using opioids for chronic pain. Now the FDA is weighing a petition asking the agency to outlaw “ultra–high” dose pills such as OxyContin 80 milligrams. The experts behind these changes argue that the benefits of these medications for chronic pain are unclear, and the risks of overdose very real: These painkillers, whether bought legally or on the black market, caused more than 14,000 fatal overdoses last year.
But people like Paul, and a vocal minority of doctors, reject the idea that prescription opioids are driving the wider crisis, and say the new policies are doing more harm than good. “Those CDC guidelines ignited a wildfire,” geriatric medicine specialist Thomas Kline of Raleigh, North Carolina, told BuzzFeed News.
Kline says it’s not chronic pain patients who are dying of pill overdoses, but rather “a group of heroin addicts” who take the pills illicitly to get high. Specialists in this camp argue that, although high-dose painkillers are linked to overdoses, no studies have yet shown that tapering medications reduces that risk. They also suggest that the lack of evidence for the pills’ effectiveness just means that no one has done a study to show something obvious — that painkillers dull pain.
The guidelines have had swift impact: Some doctors are abruptly ending prescriptions even when patients have been stable on high doses for years, throwing them into withdrawal — a soul-rending mix of nausea, agony, depression, and sometimes worse. Kline maintains a list of chronic pain patient suicides — now up to 23 names — that he attributes to having prescriptions cut off.
As opioid overdoses have officially become a public health emergency, the chronic pain debate has turned nasty, complete with insults and insinuations. Kline calls one well-known proponent of the new guidelines, Andrew Kolodny of Brandeis University, “kind of a comic book demon.” In October, a group of pain patients and doctors tried to have Kolodny fired, inaccurately claiming he wanted to force unwilling patients off opioid prescriptions. Some patients post inaccurate allegations that he has lost a child to an overdose or is profiting off rehabilitation centers.
Kolodny, meanwhile, told BuzzFeed News that he actually agrees that stable patients who are physically dependent on opioids shouldn’t have their medication stopped abruptly. But he says it’s “not a coincidence” that pharmaceutical companies support the patient organizations in an uproar over the CDC’s guidelines.
Underneath the animus, almost everyone agrees, is not so much a clash between the doctors and patients. It’s a medical system, built on 15-minute doctor visits that end with a prescription, that doesn’t effectively treat pain.
Although he had lived with a bad back for decades, Paul’s experience with high-dose opioids began in 2010, when he got a hernia after moving a desk. His body rejected the plastic mesh implanted for the hernia, which led to more surgeries, which led to more back pain. He put a lot of extra weight on his 6-foot frame, reaching a high of 221 pounds and adding even more stress on his back.
All of that led to high-dose prescriptions for Tramadol — an opioid strong enough that the FDA bars its use in children — plus up to 30 oxycodone pills a month, if he needed them. He also took Valium, an anti-anxiety drug that increases the risk of an opioid overdose.
The country was only just waking up to the opioid problem. High doses of these drugs had been reserved for cancer and hospice patients until the mid-1990s, when doctors began prescribing them for chronic pain. By 2010, high doses were standard care, at more than 10% of all opioid prescriptions for chronic pain, and the pendulum started to swing the other way.
The Department of Veterans Affairs and the American Pain Society called for cutting the highest dose prescriptions in new guidelines, triggering a slow decline. Ohio and Kentucky, among the states with the highest overdose rates, started monitoring prescriptions to prevent patients from “doctor shopping” for providers who would give them pills. Florida and other states started cracking down on “pill mill” pain clinics that handed out painkillers like candy. And over the next few years, a slew ofstudies and press reports linked high-dose prescriptions with addiction and overdose.
Whether delivered by pill, patch, or syringe, opioids can bring both pain relief and euphoria. Over time, the high may fade, but opioids still trigger a chemical dependence, as the brain stops making its own natural opioids and comes to rely on the drug instead. Nearly half of people taking opioids for a month will still be taking them a year later.
Paul’s opioid prescriptions made his pain bearable, but did not eliminate it, leaving him distracted at work by the stabbing pain along his spine. He tried many alternative treatments, from “biofeedback” (which uses electrical sensors to monitor physical changes in the body) to cognitive behavioral therapy. Nothing worked.
In the fall of 2015, stable on 300 milligrams a day of Tramadol, as well as oxycodone and Valium, Paul’s longtime doctor went on permanent leave. His new doctors presented him with a “pain contract” to sign. Its 12 stipulations included promises to undergo urine testing, alternative treatments, and detoxification treatment, if ordered. They cut off his oxycodone and Valium, but increased his Tramadol to 400 milligrams, and started giving pain shots of steroids to his back.
Without the high-dose oxycodone, Paul could no longer tolerate the days when his back pain flared up, locking him down in agony.
The CDC guidelines released in March 2016 called for avoiding opioid painkillers for chronic pain patients. For those who are already dependent, the guidelines recommend limiting prescriptions to less than the equivalent of 90 milligrams of morphine a day. Paul’s old prescriptions of Tramadol and oxycodone were above this threshold, but his new prescriptions, even with the higher dose of Tramadol, were below it.
In some cases, people do manage to cut down on their opioid use, reduce their pain, and lead more functional lives, psychiatrist and pain medicine expert Mark Sullivan of the University of Washington told BuzzFeed News. A recent study of 35 patients who wanted to cut down their painkiller doses, for example, found their lives improved and their pain wasn’t any worse after they switched to moderate doses.
“My pain got better after I got off opiates,” Ken Start, 54, of Muskegon, Michigan, told BuzzFeed News. He has written a book, Prescription For Addiction, about his 15-year painkiller addiction.
Start’s dependence culminated with a pain pump, a machine that delivered doses of pain medicine straight into his spine, that he flew down to Florida every three months to have refilled. “I thought I needed it for the pain, but I also needed it for the high,” he said. “The pain was severe, but the addiction took over and ran everything in my life.”
But not everyone has such a strong dependence. Paul dealt with oxycodone withdrawal a few times over the years, and each was a few days of flu-like misery. (It had been far more difficult to wean himself off of Cymbalta, a non-opioid antidepressant sometimes used to treat back pain.)
In 2016, shortly after the CDC guidelines were released, Paul’s doctors sent a memo to all their patients saying they were “going to start to slowly lower the opioid doses we prescribe,” in accordance with the recommendations.
With more bad days, sometimes unable to walk, Paul downshifted from working at a hedge fund to a less stressful job as a consultant, and relied heavily on relaxation techniques he learned in therapy to manage his pain.
In April of this year, a mishandled injection to his back sent Paul to the emergency room. His doctors took that opportunity to cut his Tramadol prescription, with the goal of getting him off opioids completely. During this tapering, one of his doctors called him an “addict” in front of his wife.
Pain patients often contend that they're wrongfully lumped in with people addicted to heroin and fentanyl. “The assumption is that people in pain are drug seekers. It’s widespread,” fibromyalgia patient Audrey Liebl, 44, of Springfield, Massachusetts, told BuzzFeed News.
Liebl recalled a recent trip to the emergency room for a skin infection when a nurse began interrogating her about the dosage of the opioid patch she wears for pain. “Obviously nobody starts off on a high dose,” she said. “I’ve been in pain for 20 years.”
Some doctors, too, put opioid-dependent patients into different categories. The hallmark of addiction is out-of-control drug-seeking behavior, which affects roughly 8% to 12% of chronic pain patients, according to one review. But those are the patients doctors see most often, perhaps explaining why many believe the numbers are far higher.
Adding to the confusion, the definitions of a “stable” patient on opioids versus one who “misuses” painkillers vary wildly in studies, with the latter averaging around one-quarter of patients. Few people fully adhere to their prescribed treatment plan, with many taking a pill ahead of schedule when pain flares. Smoking a joint might constitute misuse, as might drinking a beer, or even taking fewer pills than prescribed.
The opioid epidemic appears to be splitting into two epidemics, one of young people taking illegal drugs, and one of older people who, by and large, don’t. “People have to learn to inject heroin from people they know and trust,” medical epidemiologist Jay Unick of the University of Maryland, Baltimore County, told BuzzFeed News in April. It might be that older people just don't want to do that as much."
“There is a group of people who are addicted, compulsively using, despite ongoing harm to themselves,” addiction specialist Stefan Kertesz of the University of Alabama, Birmingham, told BuzzFeed News. “But there are other patients who are stable on high doses and are very worried” about the crackdown on their prescriptions, he said. The opioid pendulum is swinging too far, he added, if those patients are suddenly forced into withdrawal by doctors scared of losing their license to prescribe.
Earlier this year, Kertesz said, a younger doctor asked for his advice on pain patients who constantly wheedle, threaten, or demand higher doses of opioids. Kertesz replied by email: “If I have a guy who is working, taking care of his wife, attending Bible study, then I look at the case in a very different way than someone who is volatile and dysfunctional.”
The US medical system is ill-suited to treat pain patients with the kind of individual attention they need. There’s too little training on pain, too little time to treat people, perverse incentives to keep prescribing painkillers, and too few resources devoted to alternatives by insurers, said David Tauben, a pain medicine expert at the University of Washington, Seattle. “The problem is enormous.”
For example, until recently, doctors measured pain by asking patients to grade it on a scale of 1 to 10. “For a decade or more, many entertained the delusional idea that complex forms of human suffering could be resolved by reducing pain to a single number,” Kertesz said.
Handing out pills was a substitute for the real medical care — dedicated pain centers staffed with teams of psychologists, doctors, and social workers — that insurers, politicians, and taxpayers have been reluctant to pay for. And pharmaceutical firms have relentlessly flogged painkillers for the last two decades, despite a $600 million judgment against Purdue Pharma for its marketing of OxyContin in 2007. Just this year alone, more than a dozen states and 100 counties have sueddrug companies for deceptive marketing of painkillers to pain patients, downplaying the risks.
No X-ray, no stethoscope, only the patient can measure pain. Modern medicine, driven by blood tests and insurance rates, falters at this impasse, while chronic pain is extremely common, affecting as many as 1 in 3 US adults.
The causes of chronic pain are wide ranging and often mysterious. In theory, it results from a lowered threshold for perceiving pain signals in the brain, following an injury or illness. The patients are in real pain. And they are frequently also dealing with depression, anxiety, or genetic conditions that might worsen pain.
People with chronic pain typically have complicated medical histories, said Sullivan of the University of Washington. On top of everything else, they’re often dealing with family or work problems, and the aftereffects of past trauma, he said.
They also often distrust doctors, buffeted by multiple diagnoses and treatments through years of pain. Where the patients might see themselves as only hanging on thanks to the painkillers, physicians can see people cut off from everyone else, sleepwalking through life, still in pain, and letting their other health problems slide.
“I say to people, it doesn’t seem like this medication is actually helping, maybe it is time to try something else,” pain medicine specialist Michael Hooten of the Mayo Clinic in Rochester, Minnesota, told BuzzFeed News.
“Let’s face it, these are psychologically tough patients to deal with for physicians,” he added. “You don’t get a lot of warm fuzzy feelings from people you are trying to get to do stuff they don’t want to do.”
Doctors and patients should stop expecting to eliminate all pain, said Hooten, the Mayo Clinic pain expert. Given how often both physical and mental health problems plague chronic pain patients, he said, pain facilities should treat every aspect of their lives.
“There’s a kind of false empathy when you are providing opioids instead of really treating people, offering them false hope,” Hooten said. “We don’t need more opioids. We need more realism about living with pain.”
Paul came home from the beach and tried to explain to his wife. “My life is nothing but pain anymore,” he recalled telling her. “Please let me go so we are all in a better place.” The next morning she took him to the crisis unit of an emergency room, where he was voluntarily committed to a mental health ward.
Most of the beds there were filled with chronic pain patients, he recalled, with those considering suicide receiving treatment for two to four days, while people who attempted suicide were treated longer. Paul was released in a week, diagnosed with depression due to chronic pain.
The possible link between stopping opioid treatment and suicide has become the bedrock disagreement in the fight over the CDC guidelines. Critics like Kline warn that patients forced off opioids will kill themselves in the face of withdrawal. But many of those same patients are also diagnosed with depression, a major risk factor for suicide that needs more than a painkiller to treat. Suicide rates have skyrocketed in the last two decades, particularly the rural parts of the country where opioids were prescribed in the highest doses.
In July, back at work, Paul’s doctors cut his remaining opioid prescription in half, to 150 milligrams, and took away the Valium entirely. They took him completely off opioids in September. Now he’s on a high dose of a non-opioid painkiller, Aleve, which comes with its own side effects.
“It's crazy from the standpoint that the fear of ‘addiction’ that I haven't shown signs of in 25 years suddenly outweighs the risk of heart attacks and ulcers,” Paul said in an email.
He has trouble sleeping most nights. He drinks (“the aftereffects are terrible”), “borrows” medication from friends and family, and has tried Kratom, an unapproved botanical drug that upsets his stomach and this month garnered a health warning from FDA commissioner Scott Gottlieb. At the end of his two-year tapering from opioids, Paul says his pain is the same as when he started seven years ago.
Paul’s big hope is that New Jersey will legalize medical marijuana. To deal with flare-ups, he has even considered buying pain pills on the black market, the very threat that inspired the drive to cut down on opioid prescriptions in the first place. That’s especially dangerous with fentanyl, a dangerously potent opioid, now tainting the illegal drug market and increasingly turning up in counterfeit pain pills like the ones blamed for the 2016 death of Prince.
“I am not close to the black market yet,” Paul said, “but I feel that everyone is pushing me in that direction.”
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Trump donates third-quarter salary to HHS opioid efforts
Nov 30, 2017 | POLITICO
By Cristiano Lima
President Donald Trump has donated his third-quarter presidential salary to the Department of Health and Human Services’ efforts to combat the opioid crisis, the department and the White House announced Thursday.
“His decision to donate his salary is a tribute to this compassion, to his patriotism and his sense of duty to the American people,” acting HHS secretary Eric Hargan said during the White House daily press briefing on Thursday.
Hargan praised the president’s efforts to “drive action” in the ongoing battle to grapple with the nation’s opioid epidemic, including his October decision to declare the crisis a national health emergency.
Despite Trump's earlier promises to spend "a lot of money" on the crisis, that emergency declaration didn't include new funding to fight an epidemic that killed more than 33,000 Americans in 2015. Public health experts say billions of dollars in additional funding toward prevention and treatment measures is needed to reverse a problem that's worsening.
Hargan said the funds from the president's earnings will go toward the creation and implementation of a "large-scale public awareness campaign about the dangers of opioid addiction."
President Trump has vowed to donate his entire annual salary of $400,000 while he is in office.
White House press secretary Sarah Huckabee Sanders and Education Secretary Betsy DeVos announced his second-quarter salary donation to the Department of Education in July.
His first quarter earnings were donated to the National Park Service.
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Doctors and the opioid crisis: An AJC National Investigation
Dec 1, 2017 | Atlanta Journal-Constitution (GA)
By Carrie Teegardin
Video Link: http://www.ajc.com/news/overprescribed-investigation-doctors-the-opioid-epidemic-crisis/pbARTd9MaVYZrw28N7zaVM/
After Dr. Hasan Babaturk was fired from a medical practice for his erratic behavior, he took his prescription pad and came up with a new business model. He met patients in parking lots, shopping malls and motels, where they paid him $250 to $350 in cash. Babaturk then gave them what they wanted: prescriptions for high doses of oxycodone.
“It’s easy money,” the doctor said, explaining his mobile medical practice to the Maryland medical board.
In Georgia, prosecutors say Dr. George Mack Bird pre-signed prescriptions that his employees filled out and stocked his office with hydrocodone and other drugs for one-stop service. He stuffed proceeds — nearly $1 million in cash — in boxes and bags in his medical offices, home and vehicle.
Dr. Naga Raja Thota, a California pain management specialist, gave out hundreds of pain pills in exchange for sex. Dr. Henri Wetselaar, a 93-year-old World War II veteran who made house calls, prescribed potentially deadly combinations of opioids, Xanax and muscle relaxants to Nevada patients who had no medical need for the pills. Dr. Howard Gregg Diamond doled out hydrocodone, as well as fentanyl, even as patients kept dying of overdoses, prosecutors allege.
His Texas staff told one patient not to worry about obtaining prescriptions. “Legal drug dealing is easy,” the patient was told, according to testimony.
Drug enforcement agents trying to halt the opioid epidemic are overwhelmed by cartels that smuggle heroin from Mexico and sneak fentanyl in from China. But they also haven’t stopped some of the largest suppliers of narcotics: America’s doctors.
Years after drug companies admitted that opioids were highly addictive, years after overdoses started decimating rural communities, and years after the Drug Enforcement Administration started cuffing doctors in pill mill raids, physicians continue to flood the nation with opioids.
Well-meaning doctors who want to help patients in pain are part of the problem. But far too many licensed doctors across the nation have become drug dealers enabled by their DEA certificates.
A 50-state investigation by The Atlanta Journal-Constitution found that, since 2016, more than 1,000 doctors have been brought before medical boards for improperly prescribing opioids to patients. In that same time, nearly 150 have been in federal court on opioid drug charges. Every month, authorities bust another round of doctors gone rogue. Some doctors do it for cash, some for sex, some to keep their struggling practices afloat, the AJC found. Many leave a trail of dead patients connected to their prescription pads.
“We’re still inundated with prescription drugs,” said Vanita Hullander, the coroner in Catoosa County, a rural area of Georgia on the Tennessee state line that stands out for high rates of opioid prescribing. Hullander sees the crisis up close in the overdose deaths she must investigate and the grieving families left behind.
“There are a lot of doctors that are still writing left and right,” Hullander said, “and have no scruples and no morals about it.”
‘Doctors know best’ attitude
An opioid problem that once seemed confined to struggling corners of West Virginia and Ohio now is taking lives everywhere. Across the country, all types of drug overdoses kill more than 175 people daily, with opioid-related deathsnow far outpacing overdoses from cocaine and methamphetamine.
“If a terrorist organization was killing 175 Americans a day on American soil, what would we do to stop them? We would do anything and everything,” New Jersey Gov. Chris Christie, chairman of the national opioid commission, wrote to President Trump last month when presenting the commission’s report. “We must do the same to stop the dying caused from within.”
But how? When doctors with the legal authority to prescribe medications act more like dealers than healers, how can they quickly be stopped?
created a new unit in August to spot and prosecute more dealer doctors. Some states have imposed legal limits on opioid prescribing, after being convinced that doctors on their own wouldn’t stop doling out too many opioids. States also use databases to track every prescription, which some mine to flag and investigate high-volume prescribers.
But no state has solved the prescribing problem, including Georgia, where Attorney General Chris Carr created an opioid task force in September.
One reason: Some doctors blatantly disregard medical standards for prescribing. Other doctors think they know best and keep prescribing even after family members beg them to stop feeding the addiction of a daughter or son. Then there are doctors who get involved in blatant drug trafficking organizations.
Take Dr. Robert Gene Rand. The Nevada doctor pleaded guilty in July to involuntary manslaughter of a patient and unlawful distribution of narcotics. He was sentenced last monthto 10 years in prison. He wrote prescriptions for employees of a Ford dealership, who then sold the drugs, sometimes out of the dealership’s parking lot. Rand was also accused of seeing patients after hours to give them prescriptions for $150 cash.
From March 2011 to April 2016, Rand prescribed one patient more than 23,000 oxycodone 30 mg pills. Despite warnings and questions about the high volume of pills he gave another patient, the prescribing didn’t stop. That patient died of an overdose. Investigators in 2016 said they were looking into the deaths of 60 other patients who received narcotics from Rand.
Is it murder?
In the worst cases, a doctor who blatantly overprescribes is actually a killer.
That’s the conclusion John Niedermann reached when he started working the case of Dr. Hsiu-Ying “Lisa” Tseng.
A special assistant in the Los Angeles County District Attorney’s Office, Niedermann has built a high-profile record of going after doctors who deal. He convinced a jury in 2015 to convict Tseng of murder in the deaths of three patients who overdosed as a result of rampant over-prescribing.
While the criminal case revolved around the three deaths, many more overdosed. A general practitioner, Tseng authorized pain pills without proper evaluations or to patients who had admitted addictions. After being told repeatedly by authorities that patients overdosed, she kept prescribing.
That’s what made it murder and not just malpractice or a drug case. “In Tseng’s case, the fact that kids were dropping like once a month, I thought there has got to be something bigger here, because there has to be more liability for having so many people die, as well as being told about it and not changing your habits,” Niedermann said.
Since Tseng’s conviction, other prosecutors have connected the dots between prescribing and deaths and upped the charges to murder.
In metro Atlanta, Dr. Narendra Nagareddy, a psychiatrist, is facing felony murder charges in the deaths of six patients, who overdosed between 2011 and 2015. Nagareddy’s attorneys are putting up a vigorous defense, saying medical records will show he wasn’t dealing drugs. “There is not a doubt in my mind that Dr. Nagareddy was attempting to prescribe these medications for a legitimate medical purpose,” said David Wolfe, one of the doctor’s attorneys. A jury is expected to hear the evidence sometime next year.
Greed is often a factor in the cases of blatant over-prescribing. Doctors can easily get cash from “patients” who want prescriptions to feed their own addictions or to supply their drug-dealing businesses. Some quickly get rich. Two Alabama doctors convicted in a pill mill case pumped up their bank accounts, bought beach condos and acquired 23 luxury cars, including multiple Bentleys, Lamborghinis, Mercedes and Ferraris.
But Niedermann said it’s not just greed. He noticed that hubris was also a common trait among doctors he has prosecuted.
“They feel they are above the law,” Niedermann said. “They have always been so highly respected and deferred to. I can say that, of the dozen or so doctors that I have convicted, whenever a jury returns a verdict of guilty they look absolutely stunned. I look at them and I’m like, you sat through this month-long trial. You heard all the testimony. How are you surprised by this? But they honestly, honestly think they are doing nothing wrong.”
Doctors push back
Before he became the chief of Mississippi’s Bureau of Narcotics last year, John Dowdy spent a career prosecuting federal criminal cases.
But he was shocked when he found out how many opioids the state’s doctors were prescribing. When Dowdy started, Mississippi ranked fifth nationally for its rate of opioid prescriptions. In the latest rankings, it is fourth.
Mississippi isn’t near the top of the charts for overdose deaths, but Dowdy could see what the excessive prescribing could lead to. He is all for going after the bad apples. But he concluded that focusing only on the dealers in white coats wouldn’t be enough to fix Mississippi’s problem.
He started talking to as many Mississippi doctors as possible, to convince them that many had to immediately change the way they are treating pain.
Dowdy believes opioid prescribing climbed so high because pharmaceutical companies convinced plenty of Mississippi doctors that their painkillers were safe and effective. “The bottom line is, big pharmacy in this country, they are nothing more than legalized drug cartels” he said.
Doctors became “unknowing pawns” whose prescriptions pumped up pharmaceutical profits, Dowdy said.
In August, a governor’s task force Dowdy chaired recommended sweeping changes for doctors, dentists and even coroners who investigate overdose deaths. It’s up to the state’s medical licensing board to adopt the recommended rules for physicians, including a seven-day limit on opioids for most patients dealing with short-term pain.
But as in other states that have passed or considered similar measures, many in Mississippi’s medical community are objecting. After hearing hours of complaints at a November hearing, the all-doctor board appears likely to back down and pass less-strict rules than those recommended.
Almost every state is in the same quandary. Lawmakers and regulators want doctors to have the discretion they need, but they are tired of doctors abusing the discretion they have.
“We now have an addicted society,” Dowdy said. “And the addicted state that Mississippi finds itself in — and you can start rattling off Louisiana, Alabama, Tennessee, Arkansas and Georgia, too — is because of the prescribing habits that have been going on for the last five, six or 10 years.”
Some doctors forgiven
Going after a doctor abusing that discretion isn’t an easy task for law enforcement.
It’s not like finding a drug dealer with a bag of pills. Doctors have a legal right to prescribe narcotics, so prosecutors often have to prove that prescriptions were given for no legitimate medical purpose. That can require months of investigation, including undercover work, to prove a case beyond a reasonable doubt.
In some states, there are additional challenges.
This past July, an Alabama prosecutor had to drop criminal charges pending against a Tuscaloosa doctor arrested after complaints that he prescribed massive amounts of pain medication. Alabama court rulings say that the state drug laws used to arrest the doctor don’t apply to a licensed physician writing prescriptions for patients.
Criminal prosecution shouldn’t be the first response when questions arise over a doctor’s approach to treating patients for pain, said Rob McLendon, a Georgia attorney who is representing Dr. Bird.
Medical licensing boards are charged with protecting the public from dangerous doctors. While some have begun taking a hard line, others give doctors a pass.
New Jersey, for example, in the past 18 months has suspended or revoked numerous doctors after finding their prescribing habits were putting patients at risk, the AJC found. Michigan also has cracked down. In the past two years, Michigan has immediately suspended doctors it believes are overprescribing opioids and has put doctors on notice that it’s monitoring their prescribing habits.
Other licensing boards, most of which are dominated by practicing physicians, take a forgiving attitude, the AJC found. A doctor’s arrest on drug charges doesn’t necessarily prompt any board action in some states. Even in cases of blatant over-prescribing, doctors may only be required to pass a prescribing course before being allowed to see patients again.
In Virginia, the medical board did a thorough investigation of Dr. Jeffrey Bryan Conklin and found he violated prescribing rules for nine patients. He gave one an early refill when the patient said his dog destroyed his pain meds, and authorized another patient’s refill when she said cops took her drugs during a raid. He kept prescribing when pharmacists and an insurer questioned his practices, and after one patient overdosed, survived and came back to him for more.
The father of one patient told the doctor his daughter had a “serious, crippling” addiction and “implored” him to stop writing prescriptions for her, the board’s order shows. He did not.
The Virginia medical board reprimanded the doctor, prohibited him from treating chronic pain patients and placed him on probation. But the board allowed him to keep practicing.
He declined to comment.
Given the national crisis, many experts say it’s time for every medical board to step up and fulfill its mission.
“This will never stop until some more physicians get their licenses revoked and state medical boards start taking seriously the responsibility to ‘protect the health, safety and welfare’ of the constituents,” said Dr. John Hall, the former executive director of the Mississippi board who had urged the board to do more to punish doctors who improperly prescribed or who engaged in sexual misconduct.
New tactics coming
As everyone tries to figure out what to do to stop the opioid crisis, broad new rules are being imposed on doctors.
Retraining is one emphasis. Georgia is one of many states now requiring doctors to take classes on proper opioid prescribing.
The most aggressive states are taking a less-trusting approach with physicians.
At least 17 states now limit opioid prescribing. Massachusetts got the ball rolling with a seven-day limit for first-time adult prescriptions. Kentucky passed a three-day limit this year for short-term pain, mirroring CDC guidelines. Some states have special limits for children and teens, who are especially vulnerable to future addiction if they are exposed to opioids.
“I think legislating clinical practice is generally a bad idea. But, if the medical profession doesn’t greatly improve, it may be the least-bad alternative,” said Frieden, the former CDC director.
Individual doctors are also facing increased surveillance. Tennessee and Kentucky authorities, for example, use their prescription-tracking databases — set up to identify patients getting too many pills — to flag doctors who are high prescribers. That allows the states to spot doctors who might be a problem without waiting for complaints to come in to the medical boards.
In Atlanta, the newly appointed U.S. Attorney Byung J. “BJay” Pak said his office is all about mining the data on prescriptions. If a doctor’s numbers make him an outlier, “that’s a clear sign that something interesting is going on,” Pak said.
Pak said his office will try to bring more civil actions, in addition to criminal cases, so it can more quickly shut down doctors whose prescriptions feed addicts.
When Sessions announced his opioid unit, he pledged a data-driven effort to spot the doctors who use their prescription pads to traffick drugs. It’s an effort that’s bringing extra resources to a dozen regions. The unit’s first indictment came in October.
Dr. Andrzej Kazimierz Zielke, 62, was charged with conspiracy and unlawful distribution of controlled substances for his actions in western Pennsylvania. The region has some of the nation’s highest rates of overdose deaths.
Zielke advertised his “Medical Frontiers” office as a holistic pain management practice. Tipped to Zielke’s high prescribing of oxycodone, investigators found the doctor charged $250 in cash for visits and gave out powerful narcotics to patients for no legitimate medical purpose.
It didn’t happen in a back alley or a parking lot. But the government says it was a drug deal, not a medical appointment.
About this story
To examine the role the nation’s doctors play in the deadly opioid epidemic, The Atlanta Journal-Constitution reviewed medical board disciplinary documents issued in all 50 states and the District of Columbia from Jan. 1, 2016 through June 30, 2017. The AJC also examined federal criminal cases nationwide, as well as some state criminal cases that involved the prosecution of doctors accused of improperly prescribing opioids.
The newspaper then interviewed doctors, law enforcement officials, advocates and policymakers about the system that still struggles to quickly stop errant prescribers from fueling the epidemic. The AJC sought interviews with the doctors identified in this report. Some did not respond to messages. Others could not be reached for comment, including some who are currently in prison or jail.
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America's Opioid Crisis: A Nation Hooked
Nov 30, 2017 | Forbes
By Neil Howe
In a speech last month, President Trump declared America’s opioid crisis a national public health emergency, telling observers that “nobody has seen anything like” it. He’s right: The opioid epidemic is being called the worst public health crisis in American history, with its lethal consequences exacting a toll on users, families, and law enforcement nationwide. Though the affected span all ages, it’s Boomers (and early-wave Xers) who are pushing up overdose rates the most—a divergence from typical demographic patterns and a reflection of a risk-taking ethos that has followed these generations into maturity.
In 2015, more than 52,000 Americans died of drug overdoses. Nearly two-thirds were linked to opioids such as OxyContin, Vicodin, heroin, and fentanyl. This figure has quadrupled since 1999 and is now the highest on record, exceeding the death toll of past heroin epidemics, the crack epidemic of the 1980s, and the peak of the AIDS epidemic in the 1990s. Drug overdoses now kill more Americans than car accidents or guns. And the numbers keep rising: A preliminary analysis by The New York Times estimates that there were 59,000 to 65,000 such deaths in 2016. It’s even possible these figures are too low, because many deaths that result from opioid-induced conditions—such as pneumonia—aren’t being counted as overdoses.
The crisis is so significant that it has contributed to worsening population mortality. U.S. life expectancy fell in 2015 and has seen almost no gain since 2013. To be sure, there were other reasons behind the drop, including increased mortality for leading causes of death like heart disease. But CDC researchers cite a jump in unintentional injury deaths, namely drug and alcohol overdoses, as another major contributor.
As the number of fatalities has shot up, the public face of addiction has shifted. In contrast to past drug epidemics, opioids are killing white Americans at double to triple the rates of their black and Hispanic peers. The problem is most acute in rural areas, but transcends socioeconomic class and income level. What’s more, it’s the middle-aged who’ve been hardest hit. Though overdose death rates have risen for every age group, late-wave Boomers (ages 55 to 64) have seen the most dramatic percentage-point spike since 1999. The highest death rate (30.0), meanwhile, belongs to early-wave Xers (ages 45 to 54).
The geography of the crisis has changed over time as well. In 1999, overdose deaths were largely concentrated in Western states like New Mexico and California. By 2015, they had spread across a more diverse range of states, and the epicenter of the crisis had shifted eastward to the Rust Belt, rural Appalachia, and New England. Many victims come from overwhelmingly white areas in states like Ohio, Rhode Island, West Virginia, Kentucky, and New Hampshire. Leading the nation in per-capita overdose deaths is Ohio’s Montgomery County, which is on track for 800 fatalities this year and where the coroner’s office routinely runs out of room for bodies.
Many commentators link the opioid epidemic to economic difficulties. Princeton economist Anne Case, for example, suggests that struggling Americans are self-medicating “to soothe the beast” brought on by stress and poor health. Research by another Princeton economist, Alan Krueger, found that 44% of prime working-age male labor-force dropouts—roughly 7 million men—take pain medication on a daily basis, and in two-thirds of cases, they take prescription drugs. These men report lower levels of emotional well-being than their employed counterparts. But this theory is incomplete. Ours is not the only nation experiencing economic trauma—yet no other country is afflicted by an opioid epidemic. We consume an astonishing 80% of the world’s supply and 99% of the hydrocodone supply.
A better explanation points to something uniquely American: the U.S. medical-industrial complex, which has facilitated the massive proliferation of prescription painkillers.
In the 1990s, doctors faced pressure to treat pain more seriously as “the fifth vital sign.” They turned to opioids, which pharmaceutical companies were pushing hard (and as recent lawsuits allege, in the name of profit) as a safe solution. The U.S. health care system equates quality of care with the ability of doctors and hospitals to deliver what patients ask for, incentivizing providers to pull out the prescription pad. In 2012, doctors wrote 259 million opioid prescriptions—enough to give a pill bottle to every adult in the country. Twelve states had more prescriptions than people. The Centers for Medicare and Medicaid Services even links reimbursements to patient surveys that ask whether “your doctors did everything they could to help with your pain.”
Generational and cultural drivers are also at play. Back in the 1960s and ‘70s, there was a sizable drug abuse epidemic and most of it was driven by Boomer youth. Today, these same Boomers—having spent a lifetime dabbling in mind-altering substances—are a major driver of today’s epidemic. Research shows that Americans are more likely than Europeans to believe that “life is perfectible” (in other words, that pain is avoidable), making it all the more likely that a Boomer might seek out substances to deal with the pains of aging.
Experts are conflicted on the appropriate next step. Some say lawsuits against Big Pharma are the answer—yet even as the number of opioid prescriptions has fallen each year since 2012 (since the medical profession is at last waking up to the danger), the death rate from street drugs like heroin and fentanyl is rising faster than ever. Others maintain that the most useful tool against overdoses is the antidote naloxone, which dozens of states now offer without a prescription and law enforcement officials routinely carry.
In the meantime, the opioid crisis will continue to leave its mark on Americans of every age: babies born addicted, kids inundating foster care, addicts overdosing in public places, and grandparents who find themselves gaining custody of young children. Addiction is unique in that its effects often ripple outwards and linger for generations, leaving communities grasping to find a way out of an epidemic that shows no signs of letting up.
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New DEA Office to Open in Epicenter of Opioid Crisis
Dec 1, 2017 | The Washington Free Beacon (D.C.)
By Charles Fain Lehman
The Drug Enforcement Agency will open its 22nd division office next year in Louisville, Kentucky, bringing agency resources and focus to three states hardest hit by the nationwide opioid epidemic.
Acting DEA Administrator Robert Patterson announced the new division office during a Wednesday morning press conference. Joined by Attorney General Jeff Sessions, Patterson made clear that the goal of the Louisville office was to fight drug overdose and crime.
"DEA continually looks for ways to improve operations and interagency cooperation and more efficiently leverage resources," Patterson said. "By creating a new division in the region, this restructuring places DEA in lockstep with our partners in the area to do just that. This change will produce more effective investigations on heroin, fentanyl, and prescription opioid trafficking, all of which have a significant impact on the region."
The DEA currently maintains 21 domestic divisions, as well as 91 foreign offices in 70 countries. Previously, the Louisville field office was under the auspices of the Detroit division, covering Kentucky, Ohio, and Detroit.
The new office will be responsible for DEA investigations in the Appalachian region, specifically Kentucky, Tennessee, and West Virginia. According to the Center for Disease Control, West Virginia and Kentucky had the highest and third-highest per capita rate, respectively, of drug overdose death in 2015; Tennessee was tenth. CDC data show that of the 10 counties with the highest rate of drug overdose death, 8 are in either Kentucky or West Virginia.
"This is an area of the country that continues to see the effects of the opioid epidemic," said Special Agent in Charge D. Christopher Evans, who will lead the new office.
"The new Louisville Field Division will allow us to better address the unique needs and challenges of the central Appalachia region, and better serve the communities within it. I look forward to working with the dedicated law enforcement community here and building on the great work that is already taking place in the region," Evans said.
In addition to the establishment of the Louisville division office, Sessions announced $12 million in funding through the Community Oriented Policing Services (COPS) program to help fund state and local police forces in their fight against heroin and meth.
Sessions also announced that he would instruct U.S. attorneys to appoint an opioid coordinator to help with prosecution of opioid-related crimes. Those appointments would be expected by the middle of next month.
"These steps will make our law enforcement efforts smarter and more effective—and ultimately they will save American lives," Sessions said.
This announcement is just the latest in a series of policy changes designed to better equip the DEA to fight the opioid epidemic. Earlier this month, the agency announced its intent to schedule all illegal analogues of fentanyl, allowing the agency to more effectively prosecute fentanyl producers who skirt import bans by creating similar but chemically distinct variants of the highly toxic drug.
These actions and more are part of the Trump administration’s response to surging drug overdose deaths in America. Drug overdose death is the leading cause of injury death in the United States, and the leading overall cause of death among Americans under 50. The overwhelming majority of these deaths are attributable to opioids, especially fentanyl, which is 50 times more powerful than heroin.
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Ahlquist Targets Opioid Crisis
Dec 1, 2017 | Coeur d'Alene Press (ID)
By Mike Patrick
Candidate Ahlquist reverted to Dr. Ahlquist during an editorial board meeting Thursday at The Press.
Tommy Ahlquist, as he’s known on the campaign trail in his quest to become Idaho’s next governor, has targeted Idaho’s opioid crisis as one of the central issues demanding statewide attention. His view is shaped largely by his experience as an emergency room doctor for 18 years.
“I worked almost all night shifts and weekend shifts,” said Ahlquist, who’s in a May 15 Republican primary battle against Lt. Brad Little and U.S. Rep. Raul Labrador. “That’s when things happen; that’s when it goes down. You take care of people who are broken. For many years it was meth — meth, meth, meth. But if it’s methamphetamines, you rarely die from it.
“Opioids are different.”
Ahlquist said about 200 Idahoans die from opioid abuse annually.
From a medical perspective, Ahlquist elaborated on the history of opioids and steps taken to keep abuse under control. But that’s not nearly comprehensive enough, he said Thursday.
“Now you’ve got a lot of people who are addicted to pain medicine, which is a very common thing for a lot of people just because they had a back injury... The difference with opioids unlike any other medicine is... you have so many people who can’t get off it.”
And the state, the candidate and the physician Ahlquist believes, needs to do more to help.
“We’re wasting money on waiting until they get sick, waiting ‘til they’re in the ICU or, worse yet, ‘til they die,” he said. “With awareness, education and treatment, this is something we can take care of.”
Here’s Ahlquist’s plan to reduce the number of opioid deaths in Idaho by 50 percent in four years:
• Join six other states in declaring a state of emergency on Opioid Overdose and Deaths — addressing the more than 200 overdoses and/or deaths per year caused by this crisis: http://bit.ly/2aowy2C
• By declaring a state of emergency, he said, some federal funding would come into play.
• Use the power of the governor’s office to raise public awareness about the opioid crisis and educate families and individuals on how they can get help and help others.
• Under the leadership of the governor’s office, assemble a broad group of leaders to help fight this crisis including state and local law enforcement, first responders, medical professionals, pharmacies, primary and secondary education leaders, community leaders and churches.
• Ensure law enforcement agencies and first responders have the training and equipment necessary to fight this crisis.
• Evaluate and consider smart investments in substance abuse clinics that can help address this crisis.
• Improve data collection, training, life-saving naloxone (opioid reversal drug) dissemination, and access to medical assisted treatment programs, and non-opioid chronic pain therapies in Idaho.
• Undertake a full review of all state mental health programs including suicide prevention programs — from top to bottom — and make any improvements necessary that could help with this crisis and the overall health of Idahoans.
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Dec 1, 2017 | KSTC (MN)
By Minneapolis-St. Paul, MN
Rough Transcript: today lieutenant governor tina smith will be announcing new state guidelines to curb opioid addiction. 376 people died from opioid overdoses in minnesota last year which is a 12 per increase over 2015 . >>> meanwhile locally filed lawsuit are piling up against pharmaceutical company that make and supply opioids. thursday attorneys from hennepin, ramsey. st. louis, washington and olmstead counties announced lawsuits against three big manufacturers of opioids. they claim the businesses knew these drugs were addictive but still targeted physicians with dishonest marking . >>> this isn't money grab . >>> we're told that we can expect more lawsuits in the
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Dec 1, 2017 | WKBT (CBS)
By La Crosse, WI
Rough Transcript: executive committee meeting on december 13- th. it's not just counties in wisconsin taking legal action against the makers of those powerful painkillers. a group of county attorneys in minnesota announced yesterday they're filing lawsuits of their own. the minnesota suits accuse opioidmanufacturers and distributors of false advertising... fraud... and negligent distribution to doctors. "what we seek by filing these suits is accountability and restitution. that's what we want. this is not a money grab, we want them to help pay for the cris they have put in our laps." about 20 of minnesota's 87 counties are expected to join that state's lawsuit. more minnesotans will soon qualify for medical marijuana. starting in july... autism spectrum disorder' and obstructive sleep apnea' will be on the list of medical conditions that qualify for medical marijuana. the list is decided by people on a review panel. they consider
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Dec 1, 2017 | KSTC
By Minneapolis-St. Paul, MN
Rough Transcript: the pharmaceutical companies that make and supply the painkillers. they want to hold the manufacturers and distributors of opioids accountable for the way that they advertise. >> they knew the highly addictive properties and the update continued to market it as safe. >> the manufacturers and distributors are accused of not complying with the federal and state laws, and a half a dozen counties were represented here but many more counties are onboard and more lawsuits are expected in the weeks and months.
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Dec 1, 2017 | KQDS (FOX)
By Duluth, MN
Rough Transcript: a group of minnesota county attorneys are suing drug distributors and manufacturers over the opioid cris. the goal is to try to recover the government's cost of dealing with opioid addiction, which prosecutors say increased when drug companies amped up their marketing for opioids as a way to treat chronic pain and for long-term use. the washington county attorney says there's a correlation between that marketing and the opioid epidemic that has killed hundreds in minnesota. the group says they expect about 20 of the state's 87 counties to join the effort. several other local governments across the country have filed similar claims, alleging that manufacturers and distributors of prescription opioids are
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Dec 1, 2017 | KMSP (FOX)
By Minneapolis-St. Paul, MN
Rough Transcript: companies that well, they were after big profits and used aggressive marketing tactics knowing the drugs were highly addictive. the county is asking for accountability and restitution. >> those manufacturers through their aggressive and fraudulent marketing convinced thousands of physicians to write millions of prescriptions that led the u.s. to consume 4/5 of all opioids in the world only 4.6% of the population. >> Bill: the goal of the lawsuit is to try to recover the government cost of dealing with the opioid cris. 20 of the state's 87 counties to join thest. many of the drug companies denyingany wrong doing. >>
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Dec 1, 2017 | KARE (NBC)
By Minneapolis-St. Paul, MN
Rough Transcript: >>> 6:32 am this morning and minnesota county attorneys are suing opioid manufacturers and distributors, saying they are fed up with the staggering amount of overdoses and deaths. the attorneys claimed that it manufacturers knew that drugs were highly addictive and marketed them anyway for chronic conditions like back pain. >>> training to fight over it -- opioid overdoses with narcan, learning how to administer the antidote that they will now carry with -- carry with them. it also protects officers themselves who come in contact with opioids during searches. >>>
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KBJR 6 and Range 11 News at Ten
Dec 1, 2017 | KBJR (NBC)
By Duluth, MN
Rough Transcript: minnesota are stepping up the opioid cris fight by taking drug companies to court. today in the twin cities, county attorneys from across minnesota announced their suing the companies that make and distribute opioids. that includes st. louis county attorney mark ruben who's one of 20 there for announcement. his frustration was echoed by the washington county attorney. >> i got to tell you it's so bad that when my phone rings at night, i go into post traumatic stress because it will be something like the sheriff calling saying another dead kid, piece, another dead kid. >> Dan: the civil lawsuits filed lawsuit are just the beginning. more are expected in the coming weeks and months. the aim is to hold manufacturers and distributors responsible for their role in the opioid crisis. the lawsuits claim they knew theirrugs were highly addictive. we're learning tonight that opioid addiction may have led to the death of a man whose body
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Nov 30, 2017 | KEYC (CBS)
By Mankato, MN
Rough Transcript: opioid lawsuit>> a group of minnesota county attorneys are suing drug distributors and manufacturers over the opioid crisis. opioid makers sued>> the goal is to try to recover the government's cost of dealing with opioid addiction, which prosecutors say increased when drug companies amped up their marketing for opioids as a way to treat chronic pain and for long-term use. washington county attorney pete orput says there's a correlation betwn that marketing and the
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News 12 at Nine on FOX 12 Mankato
Nov 30, 2017 | KEYCDT2 (FOX)
By Mankato, MN
Rough Transcript: opioid lawsuit>> a group of minnesota county attorneys are suing drug distributors and manufacturersover the opioid crisis. opioid makers sued>> the goal is to try to recover the government's cost of dealing with opioid addiction, which
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Nov 30, 2017 | WCCO (CBS)
By Minneapolis-St. Paul, MN
Rough Transcript: drug manufacturers and distributors. the lawyers say the companies are contributing to the problem. they accused the companies of fraudulent marketing and negligent distribution. >> these manufactures have been sued several times in the last ten years. documents have shown this, that they knew the highly addictive properties, and yet they continued to market it as safe. >> the lawsuit seeks money for the reimbursement of expenses like law enforcement, social services, medical care, and the treatment of opioid patients. about 70 similar lawsuits have been filed across the nation. >>>
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Nov 30, 2017 | WDIO (ABC)
By Duluth, MN
Rough Transcript: st. louis county attorney mark rubin says he expects to file a lawsuit over the opioid epidemic by the end of the year. rubin appeared with counterparts in the twin cities today to explain how the cris is affecting the northland. several counties are planning legal action against pharmaceutical companies... saying this is about accountability and
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Nov 30, 2017 | KCCI (CBS)
By Des Moines, IA
Rough Transcript: in a news conference this morning they announced litigation against pharmaceutical opioid manufacturers and distributors of opioid pain medications. in saint louis county there have been 167 overdose deaths from 2011 to 2016. those overdoses involved heroin opioids and other prescription pain medications. the attorneys are hoping that the lawsuit will help slow the use abuse and illegal distribution of these highly addictive drugs.
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Nov 30, 2017 | WGTQ (ABC)
By Traverse City, MI
Rough Transcript: michigan is now joining a fight against pharmaceutical companies that have manufactured or sold prescription opioid drugs. earlier this month, grand traverse county voted to accept legal representation in a nationwide lawsuit that many other municipalities have joined. it is an effort to combat the opioid crisis and recover the years worth of money that has been spent responding to it. leelanau county was approached by a law firms in september and will be voting next month on whether to join the lawsuit.
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Nov 30, 2017 | WPBN (NBC)
By Traverse City, MI
Rough Transcript: michigan is now joining a fight against pharmaceutical companies that have manufactured or sold prescription opioid drugs, they are accepting representation that many people have joined in on. it's believed that they played and role in the opioidcrisis, leelanau county was approached by lawmakers and they'll decide whether to join the lawsuit. the board will likely vote yes. >> like most companies, it's having a tremendous impact here. we had two near fatal deaths, because of substance abuse. it's an ongoing challenge. it's not just with young people and in rural counties, we have heard issues with senior citizens with tablets and drugs and tabletsit's impacting all
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Nov 30, 2017 | KQTV (ABC)
By St. Joseph, MO
Rough Transcript: buchanan county is gearing up to take on big pharma today, county officials filed a lawsuit in federal court against the major international pharmaceutical companies for damages caused by opioid abuse. the suit claims the county has out-of-pocket costs due to the negligence of the pharmaceutical companies, claiming that they were awar of the addictive nature of the drugs but did nothing to slow their distribution to an unknowing public. county officials say much of the work of its drug strike force is combatting the sale and illegal distribution of opioids. (sot: Harry Roberts, Buch. Co. Presiding Commissioner: "We lost 26 residents between 2012 and 2016 due to opioid overdose. Obviously, there's been costs associated with that. We have a medical examiner that has to go out on every unattended death as well as many other types of death. We have costs associated with having a medical examiner. Obviously, with those people that have had to go to the
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Dec 1, 2017 | KQTV (ABC)
By St. Joseph, MO
Rough Transcript: buchan county officials filed a lawsuit in federal court against the major international pharmaceutical companies for damages caus by opioid abuse.the suit claims the county has out-of-pocket costs due to the
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Dec 1, 2017 | WMC (NBC)
By Memphis, TN
Rough Transcript: Opioid Lawsuit Update---- felicia time Shelby County Commissioners involved in an opioid lawsuit - can not be sued individually. That's the ruling form Chancellor Jim Kyle. Commission chair heidi shay-fer shafer originally filed a lawsuit challenging pharmaceutical companies contributing to the opioid cris. mayor mark luttrell then sued the commissioners, saying they over- stepped their bounds. a judge agreed, but will now ..only allow the mayor's suit to apply to their public positions as commissioners. shay-fer Shafer is now asking for mee-dee-ation mediation.
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Nov 30, 2017 | WPMI (NBC)
By Mobile, AL
Rough Transcript: 2-dozen of the largest pharmacy companies are being targeted. >> it claims big pharma knew how harmful opioids were. >> as this lawsuit grows, it has the potential to rival the big tobacco lawsuit or those against the mortgage industry. >> this story just breaking tonight. how it will impact people right here in mobile fe >> we'll bring you much more tomorrow. >> it's not the poor, it's not the rich, it's all walks of life. >> twos, nbc 15 news hosted a panel discussion on the orbing pioid cris. >> experts joins us to talk about this issue. >> you can watch the discussion for yourself on our website.
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