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Opioid Litigation Daily Media Report - 12/12/17

Northeast (PA)

Washington County files lawsuit against drug companies
Dec 11, 2017 | The Observer-Reporter (PA)
By Gideon Bradshaw

Washington County joined a phalanx of local officials from opioid-ravaged communities who are demanding to recoup the costs of fighting that epidemic from major drug companies.
City may sue makers of opioids
Dec 12, 2017 | Standard-Speaker (PA)
By Sam Galski

The city could join a growing number of states, counties and municipalities that have sued prescription opioid manufacturers and wholesale distributors to recoup costs that community leaders say are the result of an opiate epidemic.
Opioid companies sued by York County no strangers to lawsuits, settlements
Dec 12, 2017 | York Dispatch (PA)
By Jason Addy

As York County officials turn to the judicial system for help repairing some of the damage caused by rampant opioid abuse, lawyers for the companies they've sued are already fighting numerous lawsuits blaming them for launching the country’s opioid crisis.

Southeast (NC, TN, VA, WV)

County eyes legal action to fight opioids
Dec 11, 2017 | The Courier-Tribune (NC)
By Larry Penkava

Randolph County could be taking legal action against manufacturers and distributors of prescription opioids coming into the county.
Daily Digest: Chancellor Ends County Opioid Suit Injunction
Dec 11, 2017 | The Daily News (TN)
By Bill Dries

With a ruling dissolving a temporary injunction, Shelby County Chancellor Jim Kyle has ended the part of a dispute between the Shelby County Commission and Shelby County Mayor Mark Luttrell over opioid litigation that had been in Chancery Court.
Shelby County opioid fracas moves to Circuit Court
Dec 11, 2017 | Commercial Appeal (TN)
By Ryan Poe

Shelby County Mayor Mark Luttrell and the County Commission will continue their feud over who controls an opioid lawsuit in Circuit Court.
Williamson County may join lawsuit against opioid industry
Dec 11, 2017 | Tennessean
By Melanie Balakit

Williamson County may join nearly 200 other counties and cities in a lawsuit against certain pharmaceutical manufacturers and distributors of prescription opioids.
County Commission joins mass federal lawsuit against opioid distributors
Dec 11, 2017 | Franklin Home Page (TN)
By Brooke Wanser

In a special session of the Williamson County Commission, commissioners voted 20-1 to join a mass tort lawsuit against pharmaceutical companies and wholesale drug distributors in the wake of the national opioid crisis.
Hopewell Residents Take on Opioid Crisis
Dec 12, 2017 | Hopewell News (VA)
By Lyndon German

“The heroin, opioid epidemic is not a new problem,” said 1st Sgt. Harvey Smith from the Bureau of Criminal Investigation with the Virginia State Police, staring down a crowd of concerned residents and legislators.
Jefferson, Berkeley counties sue drug manufacturers, distributors
Dec 11, 2017 | The Exponent Telegram (WV)
By Linda Harris

Jefferson and Berkeley counties are suing drug companies and wholesale drug distributors, blaming them for the opioid epidemic gripping their Eastern Panhandle communities.

Midwest (IA, IN, MN, WI)

2 Iowa counties join opioid lawsuit against drugmakers
Dec 11, 2017 | Becker's Hospital Review
By Brian Zimmerman

Monroe and Sioux counties of Iowa have signed on to a lawsuit filed on behalf of more than 100 counties across eight states against five drugmakers and their subsidiaries for the companies' alleged role in facilitating the opioid epidemic, according to a Dec. 6 report from the Des Moines Register.
Bloomington And Monroe County Announce Lawsuit Against Opioid Manufacturers And Distributors
Dec 12, 2017 | WBIW.com (IN)
By Staff

On Wednesday, members of the Monroe County Board of Commissioners and Mayor John Hamilton will share details relating to a lawsuit against opioid manufacturers and distributors to be filed by the Monroe County and the City of Bloomington.
City, County To Bring Opioid Manufacturers to Court
Dec 11, 2017 | WFHB (IN)
By Staff

The City of Bloomington and Monroe County will join a lawsuit against opioid producers and their affiliates.
In Minnesotans' opioid abuse, fentanyl is a new factor. A killing factor
Dec 12, 2017 | Pioneer Press (MN)
By Christopher Magan

Jason Roberts knows he’s lucky to be alive.
St. Croix Chippewa Indians Sue Opioid Manufacturers
Dec 11, 2017 | WORT (WI)
By Staff

A Native American tribe in Wisconsin is suing opioid manufacturers in federal court in what might be the first such lawsuit in the country.

Southwest (OK, TX)

Collaboration leading Oklahoma’s opioid battle
Dec 11, 2017 | The Journal Record (OK)
By Sarah Terry-Cobo

State policymakers, agency officials and health care providers moved quickly in 2017 to collaborate on combating a deadly drug crisis.
Potter County commissioners vote to sue drug companies over opioid crisis
Dec 11, 2017 | Amarillo Globe-News (TX)
By Robert Stein

The Potter County Commissioners’ Court voted Monday to sue drug companies for fueling an opioid addiction crisis that caused economic losses to the county.
Potter County Joining the Fight Against the Opioid Crisis
Dec 11, 2017 | Myhighplains.com (TX)
By Judd Baker

Potter County has chosen to be a part of the fight against the United States' opioid crisis.
Kendall, Kerr counties prepare to sue over opioid drug abuse
Dec 11, 2017 | San Antonio News-Express
By Zeke MacCormack

Declaring that their constituents must be protected from the threat posed by opioid drugs, Kendall County commissioners on Monday authorized the filing of a lawsuit against “various drug manufacturers, developers, suppliers and others.”

West (MT)

County right to join opioid lawsuit (EDITORIAL)
Dec 12, 2017 | Bozeman Daily Chronicle (MT)
By Staff

Litigation is rarely the best way to settle differences. It’s expensive and the outcome is far from certain. But Gallatin County commissioners were wise to opt into litigation that seeks damages from pharmaceutical companies for their role in the nation’s opioid epidemic.

Commentary and FYIs

Do We Need More Generic Opioids to Battle Opioid Epidemic?
Dec 11, 2017 | Healthline
By Shawn Radcliffe

The FDA wants drugmakers to make cheaper, generic opioids that are harder to abuse. Experts question how much this will deter misuse of prescription opioids.
Meadows crafts potential opioid legislation
Dec 11, 2017 | The Mountaineer (NC)
By Kyle Perrotti

The stakes in the opioid crisis are sky-high high and rising, its tentacles leaving few areas untouched.
The Opioid Epidemic: Well, It Ain’t My fault … Maybe? (OPINION)
Dec 11, 2017 | Drug Topics (ModernMedicine Network)
By Peter A. Kreckel, RPh

You can’t pick up a newspaper from the New York Times to the Tyrone Daily Herald, without coming across an article about the opioid epidemic. There have been town hall meetings, letters to the editors, and front page stories publicizing this national emergency. From the mayors of our small towns in central Pennsylvania to the President of the United States, everyone has an opinion as to the impact of opioids on the lives of our citizens.
PhRMA Announces Major Commitment to Address the Opioid Crisis in America (PRESS RELEASE)
Dec 12, 2017 | PR Newswire
By Staff

The Pharmaceutical Research and Manufacturers of America (PhRMA) today announced a new multi-year, multimillion dollar initiative to address the opioid crisis, which will include a partnership with the Addiction Policy Forum to fund state and local programs, as well as support for new public policies that help families and individuals impacted by the crisis.
Trump administration to launch 'massive' media campaign to fight opioid crisis
Dec 12, 2017 | Washington Examiner
By Kimberly Leonard

A man named Devin, who has been in recovery from opioid addiction for more than a decade, shares what it was like to struggle with his disease. "I was stealing from people, buying substances on the street, and I look back at that time with a lot of shame, you know, that’s not who I am ... Opioid use disorder is not a moral failing," he says in a government-funded ad campaign intended to curb opioid abuse.
America's Workforce Is Paying A Huge Price For The Opioid Epidemic (OPINION)
Dec 12, 2017 | Forbes
By Nicholas Wyman

America’s opioid and heroin crisis was declared a national public health emergency last month. The epidemic claimed 64,000 lives last year - more than car accidents or guns. Opiate-related overdoses are now the leading cause of death for Americans under the age of 50. Not surprisingly, data points to a significant impact on the American workforce and the economy at large.

Broadcast Media Coverage

ABC 7 News
Dec 11, 2017 | KVII (ABC)
By Amarillo, TX

Video Link: https://app.criticalmention.com/app/#clip/view/31385166?token=df23afa8-330c-4669-8235-8e53b9b51e1a
KAMR Local 4 News
Dec 11, 2017 | KAMR (NBC)
By Amarillo, TX

Video Link: https://app.criticalmention.com/app/#clip/view/31385177?token=df23afa8-330c-4669-8235-8e53b9b51e1a
Fox 14 News
Dec 11, 2017 | KCIT (FOX)
By Amarillo, TX

Video Link: https://app.criticalmention.com/app/#clip/view/31385187?token=df23afa8-330c-4669-8235-8e53b9b51e1a

Northeast (PA)

Washington County files lawsuit against drug companies

Dec 11, 2017 | The Observer-Reporter (PA)

By Gideon Bradshaw

Washington County joined a phalanx of local officials from opioid-ravaged communities who are demanding to recoup the costs of fighting that epidemic from major drug companies.
The 104-page complaint, filed Monday in county court, alleges major pharmaceutical manufacturers and distributors engaged in misleading promotional campaigns that fueled the epidemic of opioid abuse.
The complaint alleges the defendants knew of the addictive qualities of their prescription pain medication, but continued to push the drugs onto patients long after they had left the hospital, where it was better controlled and managed.
County taxpayers have had to shoulder the burden of costs related to the opioid epidemic, according to the suit.
“The county had 27.6 drug-related arrests per 100,000 residents in 2006,” a number that exploded 1,430 percent by 2014, putting “financial strain on every aspect of the county criminal justice system,” according to the suit.
The complaint, signed by attorney Bob Peirce Jr., claims the county spends millions of dollars each year fighting the epidemic, including $2.7 million by the county drug and alcohol commission to combat abuse in the 2013-14 fiscal year alone.
In 2015, Washington County’s rate of 35.05 fatal drug overdoses per 100,000 people placed it among the top 10 in the state, according to the Drug Enforcement Administration.
Between that agency’s numbers and figures compiled by the Centers for Disease Control, the lawsuit projects a 575 percent increase in total deaths from overdoses between 1999 and 2015. It also points to increases in drug-related crime.
In November, county commissioners voted to enter into an agreement with two law firms, Marc J. Bern and Partners, LLC, and Robert Peirce and Associates, PC, to represent the county to recover taxpayers’ costs associated with the opioid crisis for a 25 percent contingent fee if the county recovers money.
The suit alleges deceptive practices, fraud, unjust enrichment, negligence, negligent misrepresentation and public nuisance. Companies named as defendants include pharmaceutical makers Purdue Pharma; Teva Pharmaceuticals; Cephalon Inc.; Johnson & Johnson; Janssen Pharmaceuticals Inc.; Ortho-McNeil-Janssen Pharmaceuticals; Endo Health Solutions Inc.; Allergan PLC, formerly known as Actavis and Watson Laboratories; McKesson Corp.; Cardinal Health Inc.; and AmerisourceBergen Corp.
It also names Drs. Russell Portenoy of New York City, Perry Fine and Lynn Webster, both of Salt Lake City, and Scott Fishman of Sacramento, Calif., who the lawsuit said were sponsored by the drug companies as promoters of opiates to treat chronic pain while “presenting the appearance of unbiased and reliable medical research.”
“There is no scientific evidence supporting the safety or efficacy of opioids for long-term use,” the suit claims. “Substantial evidence exists that opioid drugs are ineffective to treat chronic pain and actually worsen patients’ health....
“Like the tobacco companies that engaged in an industrywide effort to misrepresent the safety and risks of smoking, (the drug companies) worked with each other and with the industry-funded and directed front groups to carry out deceptive marketing.”
The county requests damages to compensate for expenditures related to the opioid epidemic; triple damages, costs and attorneys’ fees; plus punitive damages, interest and costs.
A court date was not immediately scheduled.
The commissioners of Beaver and Greene counties have filed similar suits in their counties.

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City may sue makers of opioids

Dec 12, 2017 | Standard-Speaker (PA)

By Sam Galski

The city could join a growing number of states, counties and municipalities that have sued prescription opioid manufacturers and wholesale distributors to recoup costs that community leaders say are the result of an opiate epidemic.
Council recently approved a resolution that authorizes Mayor Jeff Cusat and his administration to investigate whether it would benefit Hazleton to either join active or potential lawsuits or request information about attorneys or law firms with expertise on the subject.
Council president Jack Mundie said approval allows the city to negotiate with law firms, adding that potential legal action will be undertaken at no cost to taxpayers.
The resolution references the toll that the opioid epidemic has had on residents and emergency responders.
“Beyond the fiscal impact on the City, the human impact of this epidemic on the parents, spouses, children, siblings, and friends who have witnessed and experienced the suffering —and all too often the loss of life — of a loved one is beyond measure,” the resolution reads. “The Loss of the gifts and talents of those individuals to their families, communities, and employers remains forever.”
Cusat said he met with representatives from “a few” law firms about the possibility of Hazleton filing a lawsuit.
Municipalities typically file individual lawsuits and attorneys would decide later whether to consolidate those cases, he said.
The opioid epidemic has put a strain on emergency responders, with police having to administer Narcan more frequently and calls for opioid-related incidents on the rise, police Chief Jerry Speziale said.
“Probably 50 (percent) to 75 percent of the cost of public safety in the city is driven by opioids,” Speziale said. “Think about fire, EMS, police — the overtime, arrests, court time, burglaries, crime scenes — all the things … we have to do as a result of crime that’s driven by opioids or the people who lost their lives. That’s what’s happening around the nation.”
In Pennsylvania and other states, opioids have taken more lives than motor vehicle accidents, Speziale said.
The chief’s family was not immune the epidemic.
“Think about that,” he said. “There’s millions of cars on roadways. It transcends across every social class … there are no boundaries. As a young officer with one year on the job I had to go identify my first cousin. I lost my cousin and I lost my brother-in-law. I had to go home and tell my family. It’s devastating to people.”

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Opioid companies sued by York County no strangers to lawsuits, settlements

Dec 12, 2017 | York Dispatch (PA)

By Jason Addy

As York County officials turn to the judicial system for help repairing some of the damage caused by rampant opioid abuse, lawyers for the companies they've sued are already fighting numerous lawsuits blaming them for launching the country’s opioid crisis.
York County sued two dozen opioid manufacturers, distributors and physicians Friday, Dec. 8, for aggressively marketing their drugs and lying about the risks of long-term opioid use — allegations many of the companies have heard, and paid out large settlements for, before.
The lawsuit filed by county solicitor Glenn Smith takes aim at companies and individuals at each step of the opioid supply chain.
Four out-of-state physicians, three national drug distribution companies and 17 opioid manufacturers are facing allegations they profited from the sale and use of drugs they knew to be harmful.
“This case is about one thing: corporate greed,” Smith wrote to begin the 250-page-plus lawsuit. “Defendants put their desire for profits about the health and well-being of the York County consumers at the cost of the (county).”
Defendants: York County’s lawsuit is the latest in a string of suits filed against Johnson & Johnson, Purdue Pharma, Teva Pharmaceuticals and Allegran — four of the largest prescription drug conglomerates in the world — and major distributors McKesson, Cardinal Health and AmerisourceBergen.
Of the 17 manufacturers sued by York County, 14 are subsidiaries of the four conglomerates. Endo Pharmaceuticals, based in Malvern, Pennsylvania, and Arizona-based Insys Therapeutics are the other opioid manufacturers named as defendants in the suit.
The lawsuit will also come as little surprise to the four out-of-state physicians named as defendants, who are facing similar lawsuits in several states.
The physicians are accused of using their prominence and reputation as “pain experts” to lead a “sophisticated, highly deceptive and unfair marketing campaign” in the 1990s and 2000s to promote widespread and long-term opioid use.
Other suits, settlements: In the past year, dozens of state attorneys general and county district attorneys have filed suits against Johnson & Johnson, Purdue, Teva, Allegran and other drug manufacturers in an effort to recoup the additional costs of law enforcement, substance-abuse treatment and health care related to long-term opioid use and abuse.
The conglomerates named in York County’s lawsuit are also facing similar allegations of deceptive marketing in New Jersey, New York, Ohio, Wisconsin and New Mexico, among other states.
While none of these opioid lawsuits have yet reached a conclusion, some legal experts are projecting the total cost of settling opioid-related suits could come close to the $200 billion pricetag that the tobacco industry agreed to pay out in 1998 for deceptively marketing its products.
The county’s lawsuit does not request a specific sum of money if successful, instead seeking compensatory damages for added costs due to the defendants’ actions, punitive damages and legal costs.
Several defendants named in York County’s suit are more than familiar with paying out large sums to settle suits about their products.
Purdue agreed to pay $635 million in 2007 to settle criminal and civil charges for misbranding OxyContin, according to the lawsuit.
A year later, Cephalon agreed to pay $425 million in fines, damages and penalties for violating the Federal Food, Drug and Cosmetic Act with misleading promotions of three of its products, including a drug made from fentanyl, an opioid that’s 50 to 100 times more powerful than heroin.
The county’s lawsuit also points to a $44 million fine paid in December 2016 by Cardinal Health and a January 2017 agreement by McKesson to pay a $150 million penalty for failing to identify and report suspicious orders at a number of its facilities.
‘Blockbuster profits’: In filing the lawsuit, York County joined a growing chorus of government agencies to sue opioid manufacturers and distributors for their role in creating the opioid epidemic, which continues to reach new depths since its unofficial start several years ago.
According to York County Coroner Pam Gay, 19 people died in November from suspected opioid overdoses — the highest number she’s seen in a single month. In just the first five days of December, 10 people died from suspected overdoses, Smith said.
As of the start of December, the county had confirmed 93 heroin-related deaths and 35 suspected deaths in 2017 — 17 more confirmed deaths than last year’s total of 76, 28 more than the 2015 total of 65 and 31 more than the 2014 toal of 62.
In the lawsuit, Smith alleges the opioid companies and physicians knew “that opioids were addictive and subject to abuse” when used for chronic pain management but continued to push the drugs to boost their bottom lines.
Opioid-based treatments were once used for “short-term post-surgical and trauma-related pain,” but after coordinated and aggressive marketing techniques to persaude doctors and patients opioids were not dangerous for long-term use, “chronic opioid therapy … is now commonplace,” according to the lawsuit.
“Defendants’ scheme supplies both ends of the secondary market for opioids — producing both the inventory of narcotics to sell and the addicts to buy them,” the lawsuit alleges.
According to the lawsuit, Johnson & Johnson, Purdue, Teva and Allegran spent hundreds of millions of dollars to create a new market for opioids and earn “blockbuster profits” through creating misleading advertising, incentivizing the long-term use of opioids and buying off doctors, medial societies and patient-advocacy groups to promote opioids.
In doing so, the defendants “profited handsomely” while creating a breeding ground for addiction, overdose and death, according to the lawsuit.
Purdue recorded $45 million in revenue from its 1996 sales of OxyContin, but sales reached more than $3 billion in 2010, according to the suit.
“It was Defendants’ marketing — and not any medical breakthrough — that rationalized prescribing opioids for chronic pain and opened the floodgates for opioid use and abuse,” Smith wrote.

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Southeast (NC, TN, VA, WV)

County eyes legal action to fight opioids

Dec 11, 2017 | The Courier-Tribune (NC)

By Larry Penkava

Randolph County could be taking legal action against manufacturers and distributors of prescription opioids coming into the county.
County Manager Hal Johnson said the Opioid Advisory Council decided at its Dec. 6 meeting to recommend to commissioners that the county take such action due to the opioid crisis. The number of overdose victims has increased to the point that Randolph’s per capita figures are comparable to Mecklenburg, the largest-population county in the state.
He said any legal actions taken would be based on damage done to local citizens, including the number of overdose deaths, responses to overdose victims by Emergency Services and other impacts.
Johnson stressed that the action would not be part of a class action suit but would “look at damages just to Randolph County.” He said he would talk in more detail about the possible legal action at the commissioners’ Jan. 2 meeting, when the Opioid Advisory Council makes its recommendations.
If the commissioners agree to the legal action, Johnson said, the county will employ a national firm that specializes in this type of lawsuit to “go after companies that distribute and manufacture opioids.”
Several counties in North Carolina have already begun the process to take similar legal action in an effort to recover public costs and stop the opioid epidemic.
By the numbers
Johnson had given an update on the opioid crisis during the Dec. 4 meeting of the Randolph commissioners in preparation for the commissioners’ January agenda.
In August, the commissioners sponsored the first-ever “County Leadership Forum on Opioid Abuse” — one of the largest-attended forums at that time held in North Carolina.
“This forum had a major impact in alerting our citizens to the public health crisis stemming from the flood of opioids pouring into our county, state and nation,” Johnson said.
“Unfortunately, in Randolph County, the impact continues to increase. Our Emergency Services operations have responded from January 2017 to Nov. 12, 2017, to over 349 calls related to opioid or opioid-related drug overdose calls in all our jurisdictions. This included 25 deaths by suspected drug overdose. The numbers in Randolph County are almost equal, on a per capita basis, to Charlotte/Mecklenburg County.”
According to information from Randolph County Emergency Services, the breakdowns by jurisdiction are as follows:
* County, 168.
* Archdale, 36.
* Asheboro, 77.
* Franklinville, 4.
* Liberty, 3.
* Ramseur, 8.
* Randleman, 29.
* Seagrove, 3.
* Staley, 1.
* Trinity, 20.
The youngest was a 16-year-old overdosing on an illegal substance. The oldest was an 84-year-old accidentally overdosing on prescribed medication.
Of the 146 patients, 86 were male and 60 were female.
Expanding program
“We will soon begin the new budget cycle and our county agencies are already struggling with the increased budget costs related to the additional pressure on our resources that has been created by this opioid crisis. This includes our Emergency Services, law enforcement, Social Services, public health and many other county government agencies,” Johnson told the commissioners in the December meeting.
He said the health department and Emergency Services are working together to expand the Community Health Paramedic initiative.
“This is a program where we will be sending out a special team, consisting of paramedics and a health educator, to meet with addicts and their families. The addicts will be referred to the team by our paramedics who respond to overdose calls. This is a great partnership between Emergency Services and Public Health which will begin in January 2018.”

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Daily Digest: Chancellor Ends County Opioid Suit Injunction

Dec 11, 2017 | The Daily News (TN)

By Bill Dries

With a ruling dissolving a temporary injunction, Shelby County Chancellor Jim Kyle has ended the part of a dispute between the Shelby County Commission and Shelby County Mayor Mark Luttrell over opioid litigation that had been in Chancery Court.
Kyle originally ruled that he would not grant Luttrell’s call to void the Circuit Court lawsuit the commission filed on behalf of the county. The Circuit Court lawsuit names 24 defendants, including pharmaceutical companies and distributors of opioids.
Instead of voiding the lawsuit, Kyle gave the administration to the end of the year to intervene in the Chancery Court lawsuit.
Luttrell filed the motion to intervene, and with that, Kyle dissolved the Chancery Court injunction.
“The county made its decision on whether or not it would intervene, chose to intervene, drafted documents to intervene, and filed those documents with Circuit Court,” Kyle wrote in the Friday, Dec. 8, ruling. “It is not for the court to decide how a court of concurrent jurisdiction handles the motion to intervene. It is of no consequence to this court’s ruling that the motion to intervene was not heard on the merits and whether or not the motion is granted or denied in Division 1 of Circuit Court is irrelevant to this court.”
Attorneys for the commission had argued before Kyle last month that the county administration’s effort to void the Circuit lawsuit belonged in Circuit Court and not Chancery. Kyle’s ruling effectively puts the legal part of the controversy all in Circuit Court.

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Shelby County opioid fracas moves to Circuit Court

Dec 11, 2017 | Commercial Appeal (TN)

By Ryan Poe

Shelby County Mayor Mark Luttrell and the County Commission will continue their feud over who controls an opioid lawsuit in Circuit Court.
The Circuit Court will ultimately decide whether to allow the administration to enter and take over a lawsuit against pharmaceutical companies recently filed by the commission without the mayor's approval, Chancellor Jim Kyle clarified in a set of orders Friday.
If the Circuit Court agrees with Kyle that the mayor — as opposed to the commission — controls decisions about the lawsuit, the commission could appeal, commission attorney Allan Wade said Monday.
Because the county quickly motioned to become a party to the suit, Kyle on Friday lifted his injunction forbidding the commission and its attorneys from taking action on the case. In another minor victory for the commission, Kyle also dismissed the administration's motion to hold the commission and its attorneys in civil contempt.
However, Kyle upheld his previous ruling upholding the mayor's sole authority to enter contracts — including contracts to launch lawsuits on behalf of the county.
Commissioners launched the website after growing impatient with a perceived lack of movement on the lawsuit by the administration, even while complaining of watching their constituents suffer from the drugs. Some commissioners were also concerned that the administration would not target pharmaceutical distributors and would allow the state Attorney General to take the lead on the lawsuit, possibly reducing any local settlement.

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Williamson County may join lawsuit against opioid industry

Dec 11, 2017 | Tennessean

By Melanie Balakit

Williamson County may join nearly 200 other counties and cities in a lawsuit against certain pharmaceutical manufacturers and distributors of prescription opioids.
County commissioners authorized the mayor Monday to execute a contract with a law firm leading potential litigation against manufactures and distributors alleged to be contributing to drug addiction.
The mass tort seeks compensation for cities and counties for economic harm caused by the opioid crisis, such as the costs of addiction treatment, law enforcement and health care delivery systems.
"We say that the prescription drug manufacturers and distributors oversupplied prescription drugs, which led to the heroin and fentanyl epidemic, that prescription drugs were the catalyst," said Archie Lamb, counsel for Levin, Papantonio, Thomas, Mitchell, Rafferty & Proctor, a personal injury law firm based in Pensacola, Fla., leading the litigation.
"We're seeking to address, 'What is the cost to the community of having to deal with these people who have become addicted as result of the misconduct of companies?'" said Lamb.
More than 180 cities and counties across the country have filed claims, Lamb said. He said their firm expects 100 more to join in the next six months.
Lawsuits have been consolidated in federal court in northern Ohio, Lamb said.
Williamson County would have their own individual claim that will establish damages in the last five years and cost projections in the next 10 years, Lamb said.
County commissioners Kathy Danner, Sherri Clark and Matt Williams were absent Monday. County commissioner Brandon Ryan was the sole dissenting vote.
Participation in the possible litigation will not cost the county money, according to the resolution.
Opioid addiction and overdoses have been on the rise nationally and in the state of Tennessee. At least 1,631 Tennesseans died from drug overdoses in 2016, up about 12 percent from 2015, according to the Tennessee Department of Health.
Deaths from fentanyl and synthetic opioids increased from 169 in 2015 to 294 in 2016, according to state data.
"We're seeing more and more addiction to the pain pills, and from that they're going to the heroin. Now we're seeing fentanyl and carfentanil," said Williamson County Sheriff Jeff Long.
"We've had to use the counteractive drug Narcan recently to revive some of the people who were overdosing from heroin," Long said. "We're seeing more and more pills that are being prescribed that are being sold on the street."
He added: "People come into jail and have to be detoxed before they have to go into medical treatment. That's a cost to our citizens, and it would be great to recoup those costs for our citizens."
Since January, there have been two deaths and 17 overdoses from various drugs in Williamson County, according to Long.

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County Commission joins mass federal lawsuit against opioid distributors

Dec 11, 2017 | Franklin Home Page (TN)

By Brooke Wanser

In a special session of the Williamson County Commission, commissioners voted 20-1 to join a mass tort lawsuit against pharmaceutical companies and wholesale drug distributors in the wake of the national opioid crisis.
“Many of you know that the highly addictive substance that we often refer to as prescription opioids are ravishing our country and our state, and they’re also in our county,” Williamson County Mayor Rogers Anderson said.
During a closed session, Sheriff Long gave a presentation to the commission about the effects of the opioid epidemic on the local community.
The commission then considered the proposition to contract with Jeffrey D. Moseley of Buerger, Moseley & Carson PLC., a Franklin-based health care lawyer and Archie Lamb, also a healthcare attorney from Pensacola, Florida with Levin Papantonio.
The resolution passed with a vote of 20 to 1, with District 11 Commissioner Brandon Ryan dissenting.
Lamb is part of a larger group of counsel, representing cities like Louisville, Kentucky and Cincinnati, Ohio.
Moseley said the case filing had been consolidated in the district for Cleveland, Ohio, and that Williamson County would join 180 other communities which have already joined the suit.
Lamb said other counties in Tennessee planned to join the litigation, and their announcement was “imminent.”
The county will not pay attorney’s fees unless a settlement is reached, Moseley said.
“Prescription drug manufacturers and distributors oversupplied prescription drugs which led to the heroin and fentanyl epidemic,” Lamb said. “The prescription drugs were the catalyst.”
Lamb said the suit asserts that drug companies knew, through statistics, that they were addicting a population to drugs.
The three companies names in the lawsuit are AmerisourceBergen, Cardinal Health and McKesson Corporation. According to Lamb, these companies control 85 to 90 percent of drugs being used illegally.
Under the Controlled Substances Act, companies are required to monitor, investigate and halt excessive shipments.
“This lawsuit seeks to get compensations for cities and counties for the excessive burdens on law enforcement, on health care, on the communities at large,” he said.
Lamb said no dollar figure has been determined yet. He said he expected it would be an amount to compensate for the past five years and the effects the opioid epidemic will leave in the next decade.
“We’re seeking to address what is the cost to the community of having to deal with these people that have been addicted as a result of misconduct of the companies.”
Lamb said the lawsuit, a mass tort, was different from a class action lawsuit.
“A class action is when a bunch of people have been hurt exactly the same way. A mass tort is when a bunch of different people have been hurt differently,” he said. In turn, Williamson County will have a different claim from other communities.
Sheriff Long said last year there were 17 drug overdoses in the county, and two deaths due to overdose. He couldn’t say whether the overdoses were from opioids.
“It’s a danger that we’re seeing all the time,” Long said, describing the resources being diverted to deal with drug addictions and overdoses.
“That’s a cost to our citizens, and it would be great to be able to recoup some of that cost,” he said.

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Hopewell Residents Take on Opioid Crisis

Dec 12, 2017 | Hopewell News (VA)

By Lyndon German

“The heroin, opioid epidemic is not a new problem,” said 1st Sgt. Harvey Smith from the Bureau of Criminal Investigation with the Virginia State Police, staring down a crowd of concerned residents and legislators.
He continued saying, “It’s not a racial problem or race problem. It’s not one that affects a particular age or any particular job or educational level – it’s everybody’s problem.”
Multiple speakers from multiple fronts detailed how they’re battling the opioid epidemic in Hopewell and the state.
On Dec. 4, Delegate Lashrecse Aird hosted a community conversation at the Woodlawn Presbyterian Church. Her goal was to not only spread awareness but engage with the community.
“I want it to be a conversation and dialogue with not just those presenting but all of those gathered here tonight,” Delegate Aird spoke.
Hopewell’s community showed up in numbers as multiple Hopewell Police officers and the Chief of Police John Keohane, the Interim City Manager Charlie Dane, the Sheriff-Elect Steve Kephart, Mayor of Hopewell Jackie Shornak along with Vice Mayor Jasmine Gore, Delegate Riley Ingram and residents took their seats to hear several presenters.
The first was Daniel Herr assistant commissioner of the Department of Behavioral Health. Herr took the physiological approach in explaining just why the opioid crisis has effect so many so quickly pointing out that the “old models” of treating addiction aren’t working as best anymore, but treatment does work.
“A combination of medication assisted treatment and counseling are just as important as involving with other individuals with this experience,” Herr stated adding that it takes a community effort to get folks with addiction the attention and treatment they need.
In Herr’s presentation he referenced some national figures regarding the opioid crisis and just how quickly one might slip into a pattern of substance abuse. According to Herr 75 percent of people start their opioid addiction with prescription medication. The United States makes up about 5 percent of the population but we received 80 to 90 percent of the world’s prescription drugs.
“That shows you how our culture has dealt with pain and what’s that has meant as far as prescribing practices,” Herr asserted adding the availability of opioids along with co-addictions to tobacco, alcohol, marijuana or other substances can lead to a worst addiction.
Since 2014 fatal drug overdoses have been the leading cause of accident death in the nation Herr claimed. In Virginia along approximately 1500 people will dice from a drug overdose and those numbers are “very conservative” Herr added as two other precentors took the floor.
Chief Keohane and First Sergeant Smith took a law enforcement approach discussing some of the raw facts on how drugs are obtained and how law enforcement officers have trained to deal with the issue.
A combination of drug diversion units, public education, drug take back programs, prescription monitoring programs (PMP) and more have helped alleviate the crisis but not end it.
Hopewell’s Police Department has held 14 drug take back events – two each year. Almost 18,000 pounds of opioids have been taken off the street. Still Hopewell has also had 4 accidental deaths relating to opioid abuse and 35 overdoses this year. Chief Keohane reflected on a sad case when responding to a 70-year-old man who switched to heroin because it was the cheaper drug.
“Law enforcement can’t do it alone,” Chief Keohane said. Sergeant Smith adding that everyone has to be on the same sheet music in order to stop the problem.
The last presenter was John Shinholser and Brandi Fincham from the McShinn Foundation. Shinholser has been 30 plus years sober since being arrested in 1982 for an addiction related crime. Since then he’s dedicated his life to treating others like Brand Fincham, also a recovering addict for several years.
“I got clean in time that when you asked for help you could get it that day,” McShinn Foundation President Shinholser said saying he’s watched the destruction of a recovery system that works for the last 30 plus years. The way addiction is demonized and criminalized today has, as Shinholser said, stripped the hope from addicts.
“It’s a shame based situation – but what we aim to do is give a new person hope and hope works.” he said. In 2004 the McShinn Foundation was founded. Since its inception the program has created a circuit of intervention recovery services in communities, jails and more. Just recently the McShinn Foundation established a pilot program in Hopewell’s City Point Restoration Church of God.
The McShinn Foundation aims to help people like Brand Fincham a mother who overdoes in May of 2013 and came to McShinn with a bag of clothes, no money and a little hope. The McShinn Foundation is a snapshot of recovery but it’s far from the absolute solution.
During the question and answer portion of the segment residents took the precentors to task asking where can people be treated, what kind of training can a normal resident receive, how do we stop the supply from coming in, how do we educate the community, schools and our children? The frustration from some residents brought them to tears as the recounted cycle of substance abuse and tragedy in their families.
All in all the forum served as an appetizer to more to come and for residents to take on the battle themselves through educating their families, friends, children and the wider the community. Below are some treatment resources those residents who are or know someone who has an addiction can get help
District 19 Community Services Board at 4910 Prince George Drive, Prince George Va. as well as 20 West Bank Street, Petersburg Va.
John Randolph Medical Center 411 West Randolph Road, Hopewell Va.
Virginia South Psychiatric and Family Services 207 North Fourth Avenue, Hopewell Va.
Two River Medical Clinic 1012 Winston Churchill Drive Hopewell, Va.
Crossroads Treatment Center 10543 South Center road South Prince George, Va.
Southside Treatment Center 9609 Jefferson Davis Highway, Richmond Va.
Alamo Recovery Center 35 South Market Street Petersburg, Va.

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Jefferson, Berkeley counties sue drug manufacturers, distributors

Dec 11, 2017 | The Exponent Telegram (WV)

By Linda Harris

Jefferson and Berkeley counties are suing drug companies and wholesale drug distributors, blaming them for the opioid epidemic gripping their Eastern Panhandle communities.
The 133-page lawsuits, filed in federal court in Martinsburg, claim the drug industry boosted its bottom line by intentionally misrepresenting to consumers and to prescribers the risks of using painkillers.
Named as defendants are drug manufacturers — Purdue Pharmaceutical Products, Purdue Pharma LP, the Purdue Frederick Company Inc., Actavis Pharma Inc., Allergan USA, Allergan Sales LLC, Cephalon Inc., Ortho-McNeil-Jannsen Pharmaceuticals Inc., Johnson & Johnson, TEVA Pharmaceuticals, TEVA Sales & Marketing and Mallinckrodt Enterprises Holdings Inc. — and drug distributors — Amerisourcebergen, Cardinal Health, Cardinal Health Pharmacy Services, CVS Indiana, Endo Pharmaceuticals, Endo Health Solutions, H.D. Smith Wholesale Drug Co., McKesson, Rite Aid of Maryland, Walmart Stores East and Walgreens.
“It was (the defendants’) marketing and sales — not any medical breakthrough, that rationalized prescribing opioids for chronic pain and opened the floodgates of opioid use and abuse,” the suits contend. “The results have been catastrophic.”
The suits allege the companies worked together to convince the health-care community that pain was being under-treated and should be a higher priority, as well as marketing painkillers as “safe, effective and appropriate for even long-term use for routine pain conditions.” The counties claim the manufacturing defendants misrepresented to prescribers and consumers the risk of addiction. The counties also claim the defendants’ marketing materials “failed to portray the risk of abuse or addiction” to painkillers. Some makers marketed products for non-cancer pain that had been approved solely to treat cancer pain, the suit claims.
“... Misrepresentations about opioid abuse and addiction risk were particularly dangerous because they were aimed at general practitioners or family doctors who treat many chronic conditions, but lack the time and expertise to closely manage patients on opioids by reviewing urine screens, counting pills, or conducting detailed interviews to identify other signs or risks of addiction,” the suits allege. “Defendants have made a concerted effort to reach these practitioners through continuing medical education programs, office visits and literature specifically aimed at them, and most opioids are prescribed by primary care physicians.”
Jefferson and Berkeley leaders allege in their complaints that costs associated with addressing and fixing the opioid epidemic far exceed their budgets, so they want to hold the manufacturers and distributors “financially responsible for the economic costs of eliminating the hazards” to public health and safety.
The suits, which charge the drug makers and distributors with public nuisance, neglect, fraud, unjust enrichment and conspiracy, with a RICOH (Racketeer Influenced and Corrupt Organizations) allegation, seek unspecified damages to cover all costs associated with the opioid epidemic, including treating the addicts themselves as well as children born with opioid-related medical conditions, costs for police and emergency medical personnel response and the costs associated with caring for children of addicts.
The counties are represented by Stephen G. Skinner, Andrew C. Skinner, Laura C. Davis and Macon Bryan Epps Gray of Skinner Law in Charles Town.
The lawsuits, filed Nov. 21, were assigned to U.S. District Judge Gina Groh.

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Midwest (IA, IN, MN, WI)

2 Iowa counties join opioid lawsuit against drugmakers

Dec 11, 2017 | Becker's Hospital Review

By Brian Zimmerman

Monroe and Sioux counties of Iowa have signed on to a lawsuit filed on behalf of more than 100 counties across eight states against five drugmakers and their subsidiaries for the companies' alleged role in facilitating the opioid epidemic, according to a Dec. 6 report from the Des Moines Register.
The lawsuit, which originated in Wisconsin, collectively seeks to recoup millions in damages for the cost of local social services, law enforcement and emergency care associated with the opioid epidemic.
"These companies engaged in a false marketing campaign about the non-addictive nature of opioids for long-term use, and therefore created what we now know as the opioid epidemic," Erin Dickinson, a lawyer with the Wisconsin-based law firm Crueger Dickinson who is representing the counties, told the Des Moines Register.
A significant portion of Iowa's 99 counties could potentially join the lawsuit in the coming months, as the Iowa State Association of Counties unanimously passed a resolution last month to encourage its members to support the lawsuit, according to the report.

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Bloomington And Monroe County Announce Lawsuit Against Opioid Manufacturers And Distributors

Dec 12, 2017 | WBIW.com (IN)

By Staff

On Wednesday, members of the Monroe County Board of Commissioners and Mayor John Hamilton will share details relating to a lawsuit against opioid manufacturers and distributors to be filed by the Monroe County and the City of Bloomington.
The press conference will take place at 9:30 a.m. in the Nat U. Hill Room at the Monroe County Courthouse, located at 100 W. Kirkwood Avenue.
Members of the public are invited to attend.

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City, County To Bring Opioid Manufacturers to Court

Dec 11, 2017 | WFHB (IN)

By Staff

The City of Bloomington and Monroe County will join a lawsuit against opioid producers and their affiliates.
The city and county governments are expected to announce the legal action on Wednesday morning.
City of Bloomington spokesperson Mary-Catherine Carmichael says the lawsuit reflects local government’s belief that the burden of the opioid epidemic shouldn’t be shouldered by citizens alone.
Carmichael says the city and county have mutually shared interests when it comes to the ongoing opioid epidemic.
Carmichael did not say who would provide the funding for the legal costs.

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In Minnesotans' opioid abuse, fentanyl is a new factor. A killing factor

Dec 12, 2017 | Pioneer Press (MN)

By Christopher Magan

Jason Roberts knows he’s lucky to be alive.
A longtime heroin addict, Roberts overdosed twice on drugs laced with the man-made opioid fentanyl. He’s convinced he’d be dead today if he hadn’t been arrested for aggravated robbery in 2015 and entered an addiction recovery program.
“It’s a plague,” Roberts said of fentanyl, which is 50 times more powerful than other pharmaceutical opioids like morphine and is highly addictive.
“It’s going to be death, one way or another. Either your soul or your body will die. It’s going to kill you,” he said.
Fentanyl killed 20,000 people across the United States in 2016 and was responsible for one out of every three drug overdose deaths, according to a recent report by the Centers for Disease Control and Prevention.
And it’s here in Minnesota. Fentanyl played a role in 87 of the state’s 395 opioid-related deaths in 2016, or 22 percent, according to data from the state Department of Health. That’s more than twice as many fatalities as the year before.
But it is not a complete picture of the drug’s toll because fentanyl is often combined with other substances and is not always listed on death certificates. The drug’s most famous Minnesota victim was the musician Prince, who overdosed on pills containing fentanyl in 2016.
Carol Falkowski, an addiction specialist who has worked in state government and with recovery programs, said fentanyl presents a danger to all types of Minnesotans.
“Fentanyl is an absolute game-changer in the drug-abuse scene today, and there is no sign of it slowing down or abating,” Falkowski said. “(Minnesotans) tend to think we are immune from deep-seated societal problems. What is going on in the rest of the country is taking hold here.”
A HIDDEN DANGER
Fentanyl originated as a pharmaceutical for treating extreme pain, but it has become increasingly popular on the black market across the U.S. because it can be manufactured cheaply overseas and is extraordinarily powerful, Minnesota health and law enforcement officials say.
It is typically combined with other illicit drugs, such as heroin, cocaine or methamphetamine, in order to make those drugs more potent and valuable on the street.
Addicts don’t always know they are taking drugs laced with fentanyl, which can be lethal even in small doses.
St. Paul Police Cmdr. Ken Sass, who leads the department’s narcotics unit, said officers are on high alert about fentanyl because they don’t have a way to field test for the drug. So illicit powders police seize that are identified as heroin, cocaine or methamphetamine may also include dangerous amounts of fentanyl without officers realizing it.
“If we are doing a heroin case, we know to be more alert,” Sass said. “If officers on the street come across a powder, we’re telling them to ask the person what it is and treat it with more caution.”
The state Bureau of Criminal Apprehension can test for fentanyl, but that isn’t typically necessary if officers already have used a field test to determine a substance is a narcotic. Law enforcement is increasingly more likely to look for fentanyl in toxicology reports after a fatal overdose.
Pete Orput, Washington County attorney, is increasingly concerned about the growing number of counterfeit pills on the black market. Dealers are passing off pills containing fentanyl as prescription opioids like hydrocodone and oxycodone.
“It fools people,” Orput said. “Even a junkie thinks, ‘If it’s a pill, I know what I’m getting.’ There’s too many fakes out there, and if you’re wrong it will kill you.”
While some addicts are unaware the drugs they are taking are laced with fentanyl, others seek it out even though the potency can vary wildly from batch to batch.
“That’s why you see a spike in deaths,” Sass said. “Addicts will tell you they seek out those hot loads.”
That’s what Roberts did when he was an addict because he knew higher-potency drugs would satisfy his cravings.
“The stuff was so strong,” Roberts said. “They used to call it ‘Get high or die trying.’ ”
Roberts, who now lives in Golden Valley, finished a court-ordered recovery program provided by the Salvation Army in 2015 and now works for the organization as a dispatch manager.
SPIKE IN OVERDOSES
Fentanyl has roughly two dozen analogs that differ slightly in chemical composition and can make it hard for public safety officials to identify.
Minnesota has statewide data on fentanyl-related overdoses going back only to 2012, when the drug was listed on 27 death certificates. That same year, 14 other Minnesotans died from synthetic opioids, but it is unclear if fentanyl was a factor.
However, as opioid overdoses have skyrocketed, law enforcement and public health officials fear fentanyl may be playing an increasing role.
“It really is hard to imagine the far-reaching effects of fentanyl,” Falkowski said. “It is a contaminant … a fatal poison in the illegal drug supply.”
Data from the state Department of Health shows opioid-related deaths jumped from 54 in 2000 to 395 in 2016, an increase of more than 600 percent.
No area of the state has been immune to the crisis. Greater Minnesota saw the largest percent increase, with opioid overdoses growing a staggering 1,154 percent since 2000. The metro area had the most deaths, recording 2,337 fatalities from opioids in the past 17 years.
In Dakota, Washington and Ramsey counties, opioid deaths increased 1,000 percent or more. In 2000, just a few residents were killed by opioids; last year it was dozens.
HOW DO WE RESPOND?
Law enforcement and public health officials have realized Minnesota will not escape the opioid crisis that has devastated other states and have responded with a flurry of prevention and education campaigns along with legal actions.
Public safety officials say they are routinely talking to students and community groups about the danger of opioids. They are especially focused on prescription drugs which are often the gateway to more serious addictions.
“This is not a fad, it is not just a trend, it’s the future,” said St. Paul police commander Sass. He noted that St. Paul police have held opioid symposiums for the public, where they show “Chasing the Dragon,” an FBI-produced film about the life of an opioid addict, and take questions from the audience.
Minnesota’s county attorneys are increasingly filing criminal charges against dealers who supply drugs that cause fatal overdoses. Ramsey County has filed three such cases, and in two of them the victims had traces of fentanyl in their system.
Orput, the Washington County attorney, said the Minnesota County Attorneys Association plans to lobby the Legislature to update how fentanyl is legally defined to include the different versions arising.
“We play cat-and-mouse with the chemists, and I’m willing to keep playing,” he said.
Orput is also one of a group of county attorneys who last week announced lawsuits against the manufacturers and distributors of prescription opioids such as Oxycontin. Their lawsuits allege that deceptive marketing practices led doctors to believe the pills were a non-addictive way to manage pain.
But when patients’ prescriptions ran out they turned to illicit drugs, which can be even more dangerous because they don’t know what they are getting.
In Washington, Minnesota Sen. Amy Klobuchar is a sponsor of the bipartisan Synthetics Trafficking and Overdose Prevention, or STOP Act, legislation that would tighten oversight of packages shipped from overseas, where much of the illicit fentanyl in the U.S. originates.
“I figure if Target can find a pair of shoes with a (barcode), we should be able to track opioid packages,” Klobuchar said in an interview earlier this year.
Finally, state officials and addicts alike are pushing for wider availability of naloxone, the opioid antidote sold under the brand name Narcan. Many first responders across the Twin Cities carry nalaxone and use it routinely to revive addicts from what might otherwise be fatal overdoses.
Roberts was one of them. He overdosed in the bathroom of a North Minneapolis fast-food restaurant and woke up in the hospital. Narcan saved his life.
Roberts says making it easier for addicts to get naloxone would lower the death toll.
“Every junkie has a kit,” Roberts said, referring to the collection of syringes, tourniquets and other paraphernalia they use to get high. “Narcan should be in there, too.”

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St. Croix Chippewa Indians Sue Opioid Manufacturers

Dec 11, 2017 | WORT (WI)

By Staff

A Native American tribe in Wisconsin is suing opioid manufacturers in federal court in what might be the first such lawsuit in the country.
The St. Croix Chippewa Indians are hoping for damages from manufacturers and distributors of prescription drugs like percocet and oxycotin. They say the cost of treating addiction has burdened their community.
Well over half of Wisconsin counties have already sued pharmaceutical companies. They say those companies have engaged in fraudulent marketing of opioid painkillers and that that’s at the root of the opioid epidemic.
Like counties, tribes have had to pour resources into treating opioid addiction. Jeff Cormell is a lawyer for the St Croix Chippewa Indians, who are located in northwestern Wisconsin.
He says the strain on tribes has been even greater because the tribe pays for all its own services including a clinic, addiction facilities, a child welfare system and health providers. They’ll even help fund members who use addiction services outside the tribal system.
In addition, the St. Croix tribe uses a self funded insurance program. Cormell says that means the tribe covers a person struggling for drug addiction every step of the way.
Cormell says there were six opioid-related deaths in the community of around 1,100 last year. That doesn’t include the many more overdoses that didn’t result in death last year, Cormell says. He says the clinic responds opioid overdoses weekly.
Cormell describes the damages as they play out now as only the tip of the iceberg. One of the tribes largest expenses is their child wellfare system. He says all the cases currently in family court stem from opioid and heroin addiction.
The St. Croix suit isn’t part of the dozens of Wisconsin counties which are suing in the Eastern district of the federal court with nearly identical lawsuits. Their suit is separate, which Cormell says is thanks to the expansiveness of the effect on their insular, tribal system.
Cormell says he expects this suit to be the first of many.
Also differing from the county suits, the tribe is suing pharmacies like CVS and Walgreens, which Cormell says were complicit in over prescribing opioid painkillers. He says they’re looking to target the entire supply chain.
Producer Nina Kravinsky reports on the story.
Audio Link: https://soundcloud.com/wort-fm/st-croix-chippewa-indians-sue-opioid-manufacturers

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Southwest (OK, TX)

Collaboration leading Oklahoma’s opioid battle

Dec 11, 2017 | The Journal Record (OK)

By Sarah Terry-Cobo

State policymakers, agency officials and health care providers moved quickly in 2017 to collaborate on combating a deadly drug crisis.
But the money needed to fight that epidemic hasn’t risen proportionally, said Dr. Jason Beaman. Oklahoma Attorney General Mike Hunter said a major court case he brought against drugmakers could potentially provide a cash infusion for prevention and treatment. However, it will take several years before that money could start flowing.
Beaman and Hunter were among several who spoke Monday at the second in a roundtable series The Journal Record hosted about opioids at KOSU’s Film Row studio. Jessica Hawkins, Oklahoma State Department of Mental Health and Substance Abuse Services senior director of prevention services, and Julia Jernigan, executive director of the Oklahoma Behavioral Health Association, discussed how those who help people with brain illnesses are working to address the issue.
Hunter said since the first roundtable held in July, the stakeholders have been collaborating on identifying the issues and providing recommendations for state lawmakers. He is the chairman of the state’s opioid abuse commission, which brings together health, orthodontic and mental health providers, pharmacists, medical school professors and law enforcement agencies to develop solutions.
Funding treatment is a crucial component to addressing the crisis the state faces.
“Being smart on crime means you have to be smart on funding treatment and rehabilitation,” Hunter said. “We’ve never funded drug courts to the extent we need to.”
Oklahoma has one of the highest rates in the nation for opioid deaths. Prescriptions for the opiate-derived synthetic drugs became increasingly common for non-cancer patients in the early 2000s. In recent years, overdose deaths have skyrocketed.
Beaman, Psychiatry and Behavioral Science Department chair and professor at the Oklahoma State University Center for Health Sciences, said doctors were advised by professional societies in the last two decades that it was unethical to not treat patients’ pain.
For some who become addicted to opioids, the nationwide trend is to move on to street drugs such as heroin when they can’t get access to the pills.
Beaman said the opioid crisis meets the public health parameters for an epidemic and is akin to the bubonic plague of the 17th century or the HIV/AIDS crisis of the 1980s. But funding to the state mental health agency hasn’t risen proportionately in the last decade as opioids affect more people.
Jernigan said the state’s two medical schools are collaborating with the mental health agency to help address people who need help. There are some federal grants available specifically for opioid addiction.
Hawkins said part of the problem with federal funding is that Oklahoma must compete with other states, U.S. territories and on occasion, tribes, for that money. It’s tenuous to show scientific evidence that Oklahoma’s programs are working with short-term grants.
“We need a sustainable way to fund prevention treatment,” Hawkins said. “If we’re going to address this overall, we have to focus much more on prevention, for which we need a long-term strategy.”
Beaman said OSU’s Center for Health Sciences is working to give doctors and medical students the most accurate, up-to-date information on prescribing potentially addictive narcotics. OSU is the only medical school in the nation that requires an addiction treatment course for all its students, he said.
Hunter said he’s working to get money for addiction treatment. He is suing 13 pharmaceutical manufacturers and their affiliates, alleging there was a vast, decades-long conspiracy to deceive doctors on the addictive nature of opioids for non-cancer patients. A damage estimate hasn’t been established yet in the case, but he said Monday he’s seeking billions of dollars.
If he wins the case against the drugmakers, he said he would push to dedicate that money in a trust fund, similar to the Tobacco Settlement Endowment Trust.
“My goal would be to dedicate that money to those who have suffered,” Hunter said.
The outcome would still be a few years away; a trial date hasn’t been set and his attorneys asked the judge to schedule the trial to begin in May 2019.
He said it’s critical that the medical community continues to collaborate on reducing the number of prescription opioids available on the market. But treatment is just as important.
“But unless you have committed to funding to provide treatment options, you’re only solving half the problem,” Hunter said. “So you’re not really solving the problem.”

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Potter County commissioners vote to sue drug companies over opioid crisis

Dec 11, 2017 | Amarillo Globe-News (TX)

By Robert Stein

The Potter County Commissioners’ Court voted Monday to sue drug companies for fueling an opioid addiction crisis that caused economic losses to the county.
Commissioners approved hiring law firms from Dallas and Houston that are filing lawsuits against the companies as deaths nationwide from the drugs have skyrocketed.
Opioids include prescription painkillers like hydrocodone as well as illicit drugs such as heroin.
The firms have alleged that drug manufacturers misled the public and health care community about the usefulness of prescription opioids for treatment of chronic pain and the dangerous risk for addiction, and the resulting epidemic has drained county health care and criminal justice resources.
The law firms will front the expenses of the legal proceedings and will only take a cut of any awarded monies, said Brian Heinrich, an attorney at Templeton, Smithee, Hayes, Heinrich & Russell — one of two local firms also hired to help with the litigation.
“Potter County will never come out of pocket one penny,” Heinrich said. “Because if there’s not a recovery, Potter County will owe nothing.”
He said 28 counties had so far agreed to file lawsuits.
The two firms leading the litigation are Dallas-based Simon Greenstone Panatier Barlett and The Lanier Law Firm in Houston.
Commissioners voted 4-0 in favor of joining after discussing the fee structure.
“I just don’t think it would hurt to do it,” Potter County Judge Nancy Tanner said. “Why not? Let’s try it.”
Commissioner Mercy Murguia was absent Monday.
Potential targets for the lawsuit include OxyContin maker Purdue Pharma and drug distributors like McKesson, Cardinal Health and AmerisourceBergen.
Opioids overdoses nationwide have quadrupled since 1999, and opiates were involved in more than 33,000 deaths in 2015, according to the Center for Disease Control and Prevention.
More than 60 percent of drug overdose deaths involve an opioid, the CDC said.

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Potter County Joining the Fight Against the Opioid Crisis

Dec 11, 2017 | Myhighplains.com (TX)

By Judd Baker

Potter County has chosen to be a part of the fight against the United States' opioid crisis.
Today the Potter County Commissioner's Court voted to retain two local law firms as well as two state firms to help in litigation against pharmaceutical companies they deemed responsible.
Potter County Attorney Scott Brumley said we have seen this crisis impact many parts of America, including right here on the High Plains.
"I think that there is recognition that our community has been impacted by the opioid crisis and that impact isn't solely in terms of things that are hard to quantify," said Brumley.
The lawsuit is directed at companies that used fraudulent marketing and sales of opioids which resulted in economic loss for Potter County and its people.

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Kendall, Kerr counties prepare to sue over opioid drug abuse

Dec 11, 2017 | San Antonio News-Express

By Zeke MacCormack

Declaring that their constituents must be protected from the threat posed by opioid drugs, Kendall County commissioners on Monday authorized the filing of a lawsuit against “various drug manufacturers, developers, suppliers and others.”
Kerr County commissioners also decided Monday to pursue a similar lawsuit related to the opioid epidemic that has crippled parts of the U.S. In Bexar County, commissioners took the same step in October.
The Kendall County officials chose two law firms to work on a contingency basis to seek reimbursement of money spent by the county to combat the opioid epidemic on services such as law enforcement, emergency medical help and the incarceration of drug abusers.
“I think the right thing for us to do is to proceed forward with this,” Kendall County Judge Darrel Lux said after commissioners had conferred behind closed doors for about 20 minutes with attorney Chris Byrd.
Byrd said he’s local counsel for the lead lawyers for the litigation, Simon Greenstone Panatier Bartlett, P.C., which he said already filed several such suits on behalf of counties in U.S. District Court in the Eastern District of Texas.
Byrd said he expects the suit would be filed by March in U.S. District Court in San Antonio and predicted it will be similar to litigation his associates already filed by Upshur County against more than 20 drug and health companies.
The causes of action in that case include claims of public nuisance, common law fraud, negligence, gross negligence, violations of the Texas Controlled Substances Act and violations of the Racketeer Influenced and Corrupt Organizations Act.
The commissioners also agreed to hire Martin Walker P.C. as special counsel, also with fees for services to be paid by the county only if it recovers money on its damage claims.
In Kerr County, the commissioners hired a different set of attorneys to pursue litigation over opioid abuse.
A resolution, approved on a 3-1 vote with Commissioner Harley Belew dissenting, cites allegations that opioid manufacturers and other would-be defendants engaged in “false and fraudulent marketing resulting in addiction to opioids.”
Several law firms have actively been pitching area counties to initiate litigation over opioids, which they often liken to past suits filed against the tobacco industry.
“I do not like litigation,” said Kerr County Commissioner Jonathan Letz after Monday’s meeting, “but these lawsuits have already started nationwide and, from the taxpayers’ standpoint, not participating could have a negative impact on the county, financially.”
The professional services agreement approved by Kerr County also requires the outside lawyers to work on a contingency basis, County Judge Tom Pollard said, noting, “Their fee is 35 percent of whatever we recover. It doesn’t cost us anything if we don’t recover anything.”
The lawyers hired there work with Watts, Guerra LLP, The Gallagher Law Firm, Fibich, Leebrom, Copeland and Briggs, and Davis & Santos, P.C., according to the resolution.
One of the first tasks facing the lawyers in the litigation planned by Kerr and Kendall counties will be to develop an estimate of the monetary damages they have incurred due to opioids.
“I’ve been told that it’s going to make the tobacco litigation look like child’s play in terms of the amount of damages involved,” Pollard said.
The votes Monday in the Hill Country follow a decision in October by Bexar County commissioners to sue opioid drug manufacturers and distributors it blames for an addiction epidemic that has hit Bexar hard.
More than 100 Bexar County residents died from opioid-related overdoses in 2015, which means opioid overdoses led to almost six deaths per 100,000 in the county, according to an analysis by the San Antonio Express-News.

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West (MT)

County right to join opioid lawsuit (EDITORIAL)

Dec 12, 2017 | Bozeman Daily Chronicle (MT)

By Staff

Litigation is rarely the best way to settle differences. It’s expensive and the outcome is far from certain. But Gallatin County commissioners were wise to opt into litigation that seeks damages from pharmaceutical companies for their role in the nation’s opioid epidemic.
History will look back on this crisis with a certain amount of astonishment. The U.S. death toll from opioid overdoses reached 33,000 in 2015, about 90 every day. That’s as many as died by firearms that year and nearly has many as died in car accidents. And the victims come from every walk of life — from those living in inner-city poverty to the well-off professionals in suburbia and their children.
But the opioid epidemic wasn’t inflicted on us by violent gangs, careless gun owners or intoxicated drivers on the highway. Nor can it be blamed on the avarice of big tobacco companies.
It started from within the health care industry itself — large pharmaceutical companies who oversold the benefits of opioid painkillers and the health care providers who bought those benefits without realizing the risks that come from overprescribing these drugs. And it was helped along by drug cartels more than happy to provide cheaper, though often lethal, substitutes for prescription painkillers — heroin and the far more potent synthetic drug fentanyl.
Negotiating for compensation from the drug companies would be fruitless. Admitting liability would be hugely expensive for them, and they are certain to fight very aggressively against legal efforts to hold them accountable.
Montana Attorney General Tim Fox filed suit against the drug companies early last week. Gallatin County commissioners took on legal counsel and joined a suit filed by Cascade County in advance of the AG’s action to ensure the county would receive a share of any settlement that may eventually be reached.
State and local government taxpayers incur much of the expense for this epidemic, through legal costs for prosecuting drug cases and Medicaid costs for emergency and addiction treatment for low-income victims. Local courts alone incur more than $100,000 annually for this problem. And those taxpayers deserve to be reimbursed if the drug companies are found to be culpable.
Signing on to the opioid litigation now is the best way to make sure that happens for the citizens of Gallatin County.

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Commentary and FYIs

Do We Need More Generic Opioids to Battle Opioid Epidemic?

Dec 11, 2017 | Healthline

By Shawn Radcliffe

With the opioid epidemic in the United States showing no signs of letting up, the government has taken new steps to reduce the misuse of prescription opioids.
Last month, the U.S. Food and Drug Administration (FDA) issued guidelines to nudge drugmakers toward developing cheaper generic pain medications that are more difficult to snort, inject, or misuse in other ways.
On the surface, this move seems like a reasonable step in addressing the opioid epidemic, which kills on average 91 Americans every day, according to the Centers for Disease Control and Prevention (CDC).
But some experts say that pushing for wider adoption of harder-to-abuse prescription opioids — either generic or brand name — may not be the most effective way to reverse the epidemic.
Abuse-deterrent opioids
To date, the FDA has approved 10 prescription opioids with abuse-deterrent formulations (ADFs).
These are intended to make certain types of abuse more difficult or less rewarding, such as dissolving a capsule to inject the drug or crushing the tablet for snorting.
"The goal of ADFs is to maintain effective pain relief while reducing the potential for abuse,” said Joshua Cohen, PhD, an independent healthcare consultant and former research associate professor at Tufts Center for the Study of Drug Development (Tufts CSDD).
Several methods are used to make this happen.
For example, the abuse-deterrent version of OxyContin turns into a gel when dissolved, rather than a powder.
Other abuse-deterrent opioids release naloxone — an opioid antagonist that counteracts the effects of the opioid — when crushed.
Use of ADF opioids, though, are limited.
A report earlier this year from Tufts CSDD found that 96 percent of all opioid medications prescribed in the United States in 2015 lacked abuse-deterrent properties.
Part of the problem, said FDA Commissioner Dr. Scott Gottlieb in a press release, is that many doctors aren’t aware of abuse-deterrent opioids or they don’t know when to prescribe them.
But an even bigger barrier to wider use of these drugs is price.
So far, all ADF opioids are available only as brand-name products.
For manufacturers, this is a good thing. The higher price and the lack of generic alternatives mean a more lucrative product — especially when states require insurers to cover the cost of abuse-deterrent drugs.
The Associated Press reported last year that drugmakers were heavily lobbying states to adopt these kinds of pro-ADF opioid laws.
For insurers and the healthcare system, though, widespread adoption of brand-name ADF opioids could be financially unsustainable.
According to a post on the “Health Affairs” blog, if the U.S. Department of Veterans Affairs switched to prescribing only abuse-deterrent opioids, its yearly spending for opioids would increase from $100 million to around $1 billion.
“Branded ADFs cost much more than generic non-ADF products,” Cohen told Healthline. “In many instances, payers have balked at reimbursing branded ADFs due to cost. Thus, having generic — cheaper — versions of ADFs may improve patient access.”
Abuse-deterrent opioids no panacea
The FDA outlined several steps for speeding up the development of generic abuse-deterrent opioids.
The agency plans to help companies navigate the regulatory process in order to produce abuse-deterrent opioids sooner.
In its guidance, the FDA also provided recommendations for the types of studies that drugmakers could do to ensure that generic drugs are just as abuse-deterrent as brand-name versions.
Gottlieb emphasized that this isn’t a push by the FDA to “encourage more opioid use.” Instead, the agency hopes to shift opioid prescribing toward abuse-deterrent versions — but “only when opioids are clinically appropriate.”
Although ADF opioids can have a role in reducing the number of new addictions, they have limits.
“ADFs are not a panacea,” said Cohen. “They are opioids and, therefore, potentially addictive.”
This isn’t always clear to patients or doctors.
Dr. David Fiellin, director of the Program in Addiction Medicine and professor of medicine, emergency medicine, and public health at the Yale School of Medicine, pointed to a surveypublished last year in the Clinical Journal of Pain.
Researchers found that many primary care physicians “believe that medications that were described as ‘abuse-deterrent’ were less likely to cause addiction than those that are not abuse-deterrent,” Fiellin told Healthline.
This isn’t the case. Also, abuse-deterrent doesn’t mean “abuse proof.”
ADF opioids may be harder to misuse by crushing or dissolving them. But people can still swallow the pills whole.
“The most common way that medications such as prescription opioids are used in a non-medical fashion is just by swallowing them,” said Fiellin.
“So the mechanisms that are in place that make these medications resistant or abuse-deterrent do not impact the most common route of administration, which is orally and swallowing,” he added.
Other approaches to opioid epidemic
In spite of their lower cost, generic ADF opioids by themselves won’t be enough to reverse the opioid epidemic.
The use of generic ADFs has “the potential to impact the costs associated with the delivery of those medications,” said Fiellin, “but I think it misses the opportunity to change — in a substantial way — the overall environment and use of these medications, and the overprescribing of these medications.”
Many efforts have been made in recent years to tackle the overprescribing of opioids, which is a major driver of the opioid crisis.
Fiellin sees two areas that would likely have a “larger impact than a sole focus on abuse-deterrent formulations.”
The first is “reducing the overall level of opioid prescribing” so that it’s consistent with the scientific literature.
The potential risks and benefits of opioids also need to be carefully weighed. This includes risks to society such as prescription opioid pills being given or sold to other people, what’s known as diversion.
The CDC’s guidelines on prescribing opioids point out that “long-term opioid use often begins with treatment of acute pain.” The guidelines recommend that doctors prescribe opioids for acute pain in the lowest dose and shortest duration that is effective.
The CDC also highlights that there is little scientific evidence to support the widespread use of opioids for chronic pain.
“While some patients clearly benefit from long-term opioid therapy for chronic pain, many do not,” said Fiellin.
Long-term use of prescription opioids — even when taken as prescribed by a doctor — also carries risks. These include heart and breathing problems, opioid misuse, and opioid use disorder.
Abuse-deterrent opioids may reduce the number of pills that end up in the wrong hands. But they won’t reduce the potential physical effects.
Fiellin pointed to another area that would have a large impact — making sure that people with an opioid use disorder have “consistent and ready access to evidence-based treatments, such as buprenorphine or methadone, or even extended-release naltrexone.”
This is important because people who are already using illegal opioids such as heroin or fentanyl won’t be helped by the introduction of abuse-deterrent prescription opioids.
As well, when ADF opioids show up on the market — and the non-ADF opioids become scarcer — people may transition to heroin, fentanyl, or other illegal opioids. This was seen when the ADF version of OxyContin was introduced in 2010.
At the root of the epidemic — or one of many roots — is that we need better ways to treat chronic pain. We also need to recognize that opioids aren’t the only option available to doctors and patients.
“While attempts to create opioids that are harder to use in a non-prescribed way are important,” said Fiellin, “strategies that support non-opioid treatment of chronic pain are also likely to have an impact on the epidemic.”

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Meadows crafts potential opioid legislation

Dec 11, 2017 | The Mountaineer (NC)

By Kyle Perrotti

The stakes in the opioid crisis are sky-high high and rising, its tentacles leaving few areas untouched.
According to a recent story on Bloomberg.com citing a Columbia University study, over half of all people who died from an overdose between 2001 to 2007 were chronic pain sufferers who filled an opioid prescription with some having doctor visits shortly before their death. In addition, the story said that in the second quarter of 2017, a staggering one out of every six emergency room visits in the U.S. was opioid-related.
As the highly addictive drugs continue to drive premature deaths from both acute and chronic misuse, local and state officials have already begun taking serious action. Although building up enough steam to move the hulking federal government to act takes a bit more oomph, North Carolina Congressman Mark Meadows, along with Congressman Jim Renacci of Ohio — the state hardest hit by the opioid crisis — has introduced legislation to limit prescribers’ ability to give people more opioid-based pain killers than needed.
Meadows and Renacci outlined the legislation, called the Opioid Abuse Deterrence, Research, and Recovery Act, in an op-ed which appeared in the Mountaineer. If passed, first-time opioid prescriptions would be limited to seven days, with the following exceptions: traumatic injury, chronic conditions, cancer care, end of life care, palliative care, based on a physician’s recommendation.
The bill
In an interview with The Mountaineer, Meadows spoke at length about the legislation.
“It tries to direct some of the prescribing issues that we have with opioids and the abuse that comes with overprescribing without hamstringing the doctor-patient relationship,” he said.
Meadows said that, after speaking with numerous people in his district and Washington, D.C., it was clear that prescriptions longer than seven days carry a far greater risk for abuse. Beyond the fact that more pills mean more opportunities to become addicted, it can also lead to improper self-medication, even when the user feels it is appropriate.
“There’s also the potential for saying, ‘I had a surgery that this was appropriate for,’” he said, noting that there may be excess pills left in the medicine cabinet. “But now maybe I’ve fallen and I’ll take a couple of those pills that were left in my medicine cabinet to alleviate the pain when IB or something else might do the trick.”
There are also other aspects to the bill. Meadows said that there will be an investigation into opioid alternatives that can quell pain without the high risk for addiction. And along with requiring the Government Accountability Office to review policies that worsened the opioid epidemic, the bill also directs the FDA to determine measures to prevent people from obtaining the prescription drugs from neighboring states, which is a major issue in Western North Carolina, where anyone can travel to Tennessee, Virginia, Georgia, South Carolina, or Alabama within a few hours.
“We look to the FDA to provide some other clear standards on prescribing but also on medical records so we don’t have individuals doctor shopping across state lines,” he said, adding that he also wants to see greater recording and analysis of data.
Input — and support — from all sides
Although many pharmaceutical companies are known for pouring money into lobbying efforts, Meadows said they never worked their agenda into this legislation.
“I think some of them wanted to weigh in, but we went with what I would say the nontraditional lobbyists,” he said. “I can’t say whether they have a lobbying firm, but the North Carolina Society of Medicine was one ... But big pharma and some of the other lobbyists in terms of pharmacies played a very diminished role if any at all.”
However, that doesn’t mean those pharmaceutical lobbies don’t have their fingers in a few pies. Meadows said he thinks part of the reason he didn’t face much opposition on his bill is because those groups are gearing up for a bigger fight when it comes to fair pricing of prescription medications.
Although the pharmaceutical lobby may have been preoccupied, Meadows said he still took some flak from other groups.
“Originally, this was a lot more defined,” he said. “But we started getting pushback from some of our medical societies that say you may actually be hurting the ability or proper pain management versus those that are looking at it in a less than critical manner in their prescription methods.”
Meadows also met with numerous prescribers and law enforcement department heads — including Haywood County Sheriff Greg Christopher and Waynesville Police Chief Bill Hollingsed —before crafting his legislation.
“This particular bill was actually the result of meeting with law enforcement officers and medical personnel in the district, and that’s where it started,” Meadows said. “It was probably six months in the working. We worked with the North Carolina medical society, we worked with Duke University, we worked with The Association of Orthopedic Surgeons, American Enterprise Institute, and Law enforcement officers.”
In addition, Meadows has tried to keep President Trump — who has spoken about this issue at length, and even formed an opioid taskforce that includes North Carolina Governor Roy Cooper — in the loop.
“They’re aware that we’re working on this legislation and this legislation came out about the same time Kellyanne Conway was named as the drug czar,” he said. “Kellyanne Conway and I have a very good working relationship and we’re forwarding the bill to her so they can look at either modifications or whether they want to move that forward.”
Meadows said the bill has received solid bipartisan support thus far, and some have reached across the aisle to address the issue.
“I talked to (Democratic Maryland Congressman) Elijah Cummings briefly yesterday,” he said. “We had just had an opioid hearing in his district this week. They’re passing that along to some of my Democrat colleagues to look at that.”
Just the beginning
Some elements of this bill mirror the STOP act, which was sponsored in North Carolina Senate by Jim Davis, who represents Haywood County. Although the STOP Act goes much farther than Meadows’ proposed legislation, state lawmakers ran into an issue when they couldn’t apply the law to federal prescribers, such as the Department of Veterans Affairs. However, Meadows’ legislation will apply to these organizations.
“This sets a federal standard,” Meadows said.
The legislation put forth by Meadows and Renacci is a sure step in the right direction, but it’s one that Meadows admitted is a bit of a baby step. In fact, some in congress have already started floating more ideas.
“Another idea that would cost additional money would be reimbursement for Medicare, Medicaid, and insurance gets reimbursed for pain killers that may not have the same addictive nature,” he said. “Right now, Medicare and Medicaid will preclude some of thsoe either based on cost or based on a patients age. We’re working with the FDA on that.”
Although Meadows is notorious for being a fiscal conservative not fond of shelling out taxpayer dollars for government programs, he admitted that, when it comes to combatting the opioid crisis, there should be an allocation of some serious funds.
“I’ve been one that’s been a proponent of that,” he said. “Before I was in congress, I put some of my own personal money into some ventures. One was education program for kids from elementary to middle school. In addition, I’ve put money forward for scholarships for people willing to work with us on drug prevention aspects. It’s not widely reported, but I had done that prior to being a member of congress, and I’d seen value in not only the educational side of that but also from the treatment point of view. So yes, additional dollars for that would be appropriate.”
He added that there are opportunities to wisely use any additional funding.
“As we introduce this bill, several other ideas came up,” he said. “I was having a conversation yesterday with a senator where we were talking about NIH funding. They believed that the federal government would match private industry and have each pharma company put up several hundred million dollars, and have a matching fund through the NIH funding.”
While this bill may be small in terms of scope, Meadows said it will further the greater conversation and pave the way for more effective legislation.
“The real message needs to be this: if this is all we do, we have not done enough,” he said. “This is a start on what we do, then we can applaud and realize we’re all moving in the right direction.”

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The Opioid Epidemic: Well, It Ain’t My fault … Maybe? (OPINION)

Dec 11, 2017 | Drug Topics (ModernMedicine Network)

By Peter A. Kreckel, RPh

You can’t pick up a newspaper from the New York Times to the Tyrone Daily Herald, without coming across an article about the opioid epidemic. There have been town hall meetings, letters to the editors, and front page stories publicizing this national emergency. From the mayors of our small towns in central Pennsylvania to the President of the United States, everyone has an opinion as to the impact of opioids on the lives of our citizens.
I was at such a meeting with our local state representative, Judy Ward, who is also a nurse. One member of the audience raised her hand and said, “We ought to sue those drug manufacturers. They created this problem.” Without missing a beat, Rep. Ward pointed out there were two pharmacists in the room, and she would like to hear our opinions.
I began by saying, “You are absolutely right. The drug companies are at fault. Let’s sue them.”
The drug companies will say, “We never sent out a bottle of our product to any warehouse that didn’t order it. Let’s sue the wholesalers.”
The wholesalers can say, “We’ve never sent out a product to stores that didn’t order it, on a special triplicate form called a DEA 222! Let’s sue the pharmacies/pharmacists.”
The pharmacists can say “I’ve never ordered a bottle of narcotics that I didn’t need, and I needed them is because the physician wrote a prescription for them. It’s the doctors fault. Let’s sue them.”
The doctors will say, “I’ve never written a prescription for a patient who didn’t need, in my clinical judgement, an opioid. It is the patients fault for being so demanding. Let’s sue them!”
I said I had witnessed the head of our local emergency department stand nose to nose with the Secretary of the Pennsylvania Department of Drug and Alcohol Programs. He was saying that government patient satisfaction surveys were part of the problem in his area of practice. The government demands that the patients be happy and satisfied and giving many of these patient’s opioid prescriptions will make them happy and satisfied. So it’s the government’s fault. Let’s sue them.
I told the crowd, that this problem is so huge, that indeed there is enough blame to go around. Suing any one of the parties will accomplish nothing.
My son-in-law, Mark Garofoli, PharmD, MBA, BCGP, has the ominous task of attempting to make progressive changes at ground zero in the opioid epidemic, his home state of West Virginia. He coordinates an interprofessional panel of pain management experts including doctors, interventionists, pharmacists, and nurses with the goal of saving and improving lives by facilitating the shift of best practices in pain management to a new standard of care. Health insurance representatives on the panel are working to accomplish the same, which is contrary to typical situations in other states where insurance companies have reacted quickly and with the least amount of thought. Limiting a patient to 160 mg morphine equivalents (MME), who was using more than 600 MME/day just last month is simply ludicrous. That isn’t patient care. It is patient neglect.
Where do we pharmacists fit into the picture? We need to go no further than the Title-1 Code of Federal Regulations. Section 1306.04A states: a “prescription for a controlled substance to be effective must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice. The responsibility for the proper prescribing and dispensing of controlled substances is upon the prescribing practitioner, but a corresponding responsibility rests with the pharmacist who fills the prescription.”
My son-in-law put it more accurately: “Dad, it’s only a sheet of paper, until you act on it.”
Count me in to be part of the solution!

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PhRMA Announces Major Commitment to Address the Opioid Crisis in America (PRESS RELEASE)

Dec 12, 2017 | PR Newswire

By Staff

The Pharmaceutical Research and Manufacturers of America (PhRMA) today announced a new multi-year, multimillion dollar initiative to address the opioid crisis, which will include a partnership with the Addiction Policy Forum to fund state and local programs, as well as support for new public policies that help families and individuals impacted by the crisis.
In the coming months, PhRMA and the Addiction Policy Forum will work together to implement the Forum's four-year vision plan to help solve the opioid crisis, titled "Priorities to Address Addiction in America," released in October 2017. The plan identified eight strategic focus areas to address addiction; the recommendations included analysis of key states to identify gaps in existing programs, increased education efforts for patients and families and the development of an online portal to connect individuals with addiction treatment options and information. The biopharmaceutical industry's commitment will allow the Forum to implement programs nationwide, including prevention initiatives, an online addiction resource center, public-private partnerships and new tools and protocols for health systems, among other initiatives.
"We are deeply committed to addressing the opioid crisis and advancing solutions that will make a meaningful difference for families and communities," said PhRMA President and CEO Stephen J. Ubl. "This is only possible if we make a point to listen, partner with organizations and experts on the ground, and ensure that our top priority is saving lives. The Addiction Policy Forum is actively working to provide resources to reduce the stigma surrounding addiction and treatment, and we are proud to support their efforts through this new partnership."
"The challenge in front of us requires that everyone be at the table, working together to implement comprehensive, long-lasting solutions that will save lives," said Jessica Hulsey Nickel, President and CEO of the Addiction Policy Forum. "We look forward to partnering with leaders in the biopharmaceutical community to help states, cities, towns and families change the trajectory of this crisis."
In addition to announcing the partnership with the Forum, PhRMA also released an expanded set of policy proposals to aggressively tackle the many drivers of the crisis. The new platform supports policies that limit the supply of opioid medications to 7-days for acute pain with clear exemptions; mandate prescriber training to ensure appropriate treatment of addiction and pain and eliminate coverage barriers that keep patients from accessing all forms of addiction treatment, including medication assisted treatments, and recovery support.
To accelerate the development of innovative new treatments and therapies, PhRMA recently announced it's working to establish a public-private partnership with the National Institutes of Health (NIH), the National Institute on Drug Abuse (NIDA) and leaders in the biopharmaceutical industry. The partnership will help bring both non-opioid, non-addictive pain medicines and improved medication assisted treatments for addiction to patients sooner. There are currently 40 non-opioid analgesics and 40 addiction and overdose treatments in the development pipeline.
About PhRMA
The Pharmaceutical Research and Manufacturers of America (PhRMA) represents the country's leading innovative biopharmaceutical research companies, which are devoted to discovering and developing medicines that enable patients to live longer, healthier, and more productive lives. Since 2000, PhRMA member companies have invested more than $600 billion in the search for new treatments and cures, including an estimated $65.5 billion in 2016 alone.

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Trump administration to launch 'massive' media campaign to fight opioid crisis

Dec 12, 2017 | Washington Examiner

By Kimberly Leonard

A man named Devin, who has been in recovery from opioid addiction for more than a decade, shares what it was like to struggle with his disease. "I was stealing from people, buying substances on the street, and I look back at that time with a lot of shame, you know, that’s not who I am ... Opioid use disorder is not a moral failing," he says in a government-funded ad campaign intended to curb opioid abuse.
Devin now has a family, a master's degree, and a career, and his story is part of an awareness campaign that aims to educate the public about the dangers of opioid abuse. Devin's addiction began with a 30-day prescription from a doctor around the age of 16, following a procedure to remove his wisdom teeth.
The ad, among others, is part of an "Rx Awareness" pilot program that has been running since September in parts of Kentucky, Ohio, Massachusetts, and New Mexico that have high rates of addiction. The program, by the Centers for Disease Control and Prevention, is set to run for 14 months as health officials evaluate if the ads are reaching the right audiences and how to boost messaging on those that are working.
President Trump recently joined the effort by donating his third-quarter salary of $100,000 to build off the ad campaign. Creating an "aggressive media campaign" on the dangers of drugs and framing it as a disease rather than a moral failing is one of 56 recommendations laid out by the opioid commission he created, which is led by outgoing New Jersey Gov. Chris Christie.
The larger ad campaign to come will be "massive," Trump vowed as he delivered a speech in October directing his administration to declare the crisis a public health emergency.
The administration has not said how much it will spend on the larger campaign. The Trump administration has said Congress must appropriate funds for the opioid crisis but hasn't put out a specific request or detailed which recommendations from the commission it plans to follow.
The pilot ads that have aired are different from the anti-drug messaging delivered to young people during the 1980s and 1990s. In those ads, teens were instructed to "just say no" to drugs and shown videos of an egg frying in a pan as a voice-over said, "This is your brain on drugs." Studies have shown that the ads were not effective in changing behavior.
The message has evolved for approaching the opioid crisis, partly because many opioid addictions begin with a prescription from a doctor for painkillers such as oxycodone or hydrocodone. After patients become hooked, they turn to the drug's cheaper street counterpart, heroin, which has increasingly been laced with fentanyl, a more potent opioid. As a result, more than 33,000 people in 2015 died from opioid-related overdoses, according to latest available data from the CDC.
A Department of Health and Human Services official said other messages will remind people who take prescription painkillers to use them appropriately and will contain information about helping friends and families support people close to them who have addictions or have overdosed.
The other pilot program ads detail how a person's addiction began with a prescription, how quickly they succumbed to addiction, and the losses that followed: a job, a home, or the death of a family member. Each video is accompanied with the message: "Prescription opioids can be dangerous. It only takes a little to lose a lot," and then directs viewers to the CDC's online campaign.
Evidence about the effectiveness of public health campaigns is mixed. The opioid commission acknowledged that in its report, saying that even though awareness can be increased through ads, they aren't always successful in changing behavior. Including information about where to receive treatment would be key, the commission concluded.
A 2010 study in the Lancet, a medical journal, found that results varied according to the behavior being targeted and what kind of message was promoted. For instance, it found strong evidence that ads targeted at smoking changed behaviors, but that ads about alcohol showed little evidence of any benefit and ads on nutrition were more effective when they promoted healthy foods.
The Obama administration credited a $54 million anti-smoking campaign called "Tips from Former Smokers" with helping 100,000 people quit. The ads featured smokers discussing some of the side effects they faced, such as losing their voice boxes to cancer, having a high-risk pregnancy or losing teeth. HHS Acting Secretary Eric Hargan recently touted the CDC's anti-smoking campaigns in a recent visit to the agency.
Advocates tend to agree that a mass media campaign, when done with accurate and helpful information, can be an effective part of prevention.
"We know ad campaigns work. That's why the private sector uses them all the time," said Dr. Georges Benjamin, executive director of the American Public Health Association.
He adds that such advertising campaigns tend to be expensive. In 1998, the annual funding request for an anti-drug media campaign aimed at youths was $200 million a year, a sum that was doubled because it was matched by outside entities.
The money for such campaigns involves conducting studies on an audience, laying out which behaviors the agency is trying to change, doing trial runs and then tracking how effective the ads are, Benjamin said.
He stresses that the ad campaigns should be part of a broader strategy that involves access to treatment, regulatory changes, and tackling the black market. He acknowledged that several strategies have been implemented by different health agencies under the Trump administration, but said it would help to have a blueprint to know how the ad campaign would fit into a broader plan.
Dr. Corey Waller, chairman of the legislative advocacy committee for the American Society of Addiction Medicine, agreed.
"There are 'things' going on," he said, specifically using quotation marks. "The problem is I’m not able to see a coordinated, concerted effort to build the addiction ecosystem that we need."
Trump's comments on the topic have been mixed. Solving the crisis would "require us to address the crisis in all of its very real complexity," the president said in his Oct. 26 speech declaring the opioid crisis a public health emergency. He also, however, stressed the need to have children avoid using drugs in the first place. He drew on his own experience avoiding tobacco and alcohol because his brother Fred died from alcoholism.
"The fact is, if we can teach young people, and people generally, not to start, it's really, really easy not to take them," Trump said.
That portion of the speech drew criticism from those who likened it to the "just say no" anti-drug campaigns during the 1980s, such as the Drug Policy Alliance, which opposes the way the U.S. has pursued anti-drug policies that have stressed criminalization and resulted in massive incarceration.
The opioid commission pushed back on such characterizations.
“The commission, through its report, made clear that opioid addiction is a complex issue with many factors, including the fact that many people start with an opioid prescription for legitimate medical use," said Brian Murray, press secretary for Christie. "The recommendations speak for themselves in regards to messages that can be delivered to the public. If anyone thought that saying 'just say no' were the solution, there would not have been a commission formed or a resulting 100-plus page report delivered with specific suggestions on combatting this crisis.”
The commission recommended a similar campaign to the one issued during the AIDS epidemic, which sent a mass mailer to U.S. households to educate the public about how the virus was spread. It also cited a Food and Drug Administration anti-smoking campaign called "The Real Cost" as an example to emulate.
Waller said that if the administration "puts all its eggs in one basket," it could go a long way toward reducing stigma about addiction.
"The biggest area is in decreasing stigma ... that this is a chronic brain disorder and not bad decision-making," he said. "I think we have to continue that."

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America's Workforce Is Paying A Huge Price For The Opioid Epidemic (OPINION)

Dec 12, 2017 | Forbes

By Nicholas Wyman

America’s opioid and heroin crisis was declared a national public health emergency last month. The epidemic claimed 64,000 lives last year - more than car accidents or guns. Opiate-related overdoses are now the leading cause of death for Americans under the age of 50. Not surprisingly, data points to a significant impact on the American workforce and the economy at large.
An October PBS NewsHour report, “How Opioids Have Decimated the American Workforce,” looked at a region in Ohio where employers are hard-pressed to fill job openings for skilled workers. The CEO of Columbiana Boiler Company, Michael Sherwin, said his company has had job vacancies lasting up to two years. He estimated a business loss of $200,000 a year due to the lack of skilled workers. In many cases, candidates who have the necessary skills are unable to pass drug screenings. Sherwin said they have to turn down about 25 percent of qualified applicants for this reason. The report highlighted the story of one skilled welder who had been out of the workforce for three years due to an opioid addiction that began a decade ago when he was prescribed Vicodin for pain, as well as a machinist whose struggle with addiction had kept him out of the workforce for six years.
Even as employers across industries face skilled labor shortages, a growing number of working age men and women are disappearing from the workforce. The labor force participation rate has been declining since 2000, with a notable and consistent decline in labor force participation among men aged 25-54.
Princeton economist Paul Kruger has linked the rise in opioid prescription rates by county with a decline in labor force participation of men and women alike. His findings suggest that the opioid crisis could account for as much as twenty percent of the decline in LFP of working-age men.
Construction and manufacturing - two major industries dealing with skilled labor crunches - are being hit hard by the opioid crisis. Recent reports from insurer CNA Financial Corp showed that spending on opioid prescriptions is consistently five to ten percent higher in construction than any other industry. Spending tends to be higher in manufacturing than in most other industries, CNA also found.
Employers And Unions Tackling The Problem
A group of construction industry stakeholders in St. Louis is confronting the problem head-on. Last December, Construction Forum STL devoted their December panel to the topic, titling the forum “Opioids: A Building Epidemic.” The panel brought together union leaders, medical experts and addiction recovery specialists for a frank discussion about the opioid crisis and what can be done about it.
Don Willey spoke candidly at the forum about his 36-year-old son’s death in 2016 from an overdose, which followed a 15-year struggle with addiction.
“Over the last few years when people would ask about my kids, I would tell them Matt struggles with life. He is a heroin addict,” Willey said. “If I couldn’t admit his addiction, how could I expect him to? And it was only right to make people aware.”
Willey is the business manager for the Laborer’s International Union of North America Local #110 in St. Louis. Since his son’s death, he has led efforts within his union to raise awareness about addiction and the challenges faced by individuals and families who are struggling with it.
Robert Riley, a recovery specialist on the STL panel, emphasized that addiction is a medical issue. “An addict’s brain has been hijacked,” Riley said. “Their body is telling them that before they eat, sleep, reproduce, take a breath - they need to put opiates in their system.” Riley also said, “It starts with the prescription drugs and that’s what we need to educate people on.” Recent data suggests that four out of five heroin users started down this destructive path via prescription opioids.
The dramatic increase in opioid prescriptions over a 15-year period is at the root of the epidemic. Sales of prescription painkillers in the U.S. quadrupled between 1999 and 2010, according to the Centers for Disease control and Prevention. The CDC also reports that since 1999, deaths from prescription opioid overdoses have quadrupled.
At the end of the forum, the moderator asked for a show of hands from those whose lives had been touched by the opioid and heroin epidemic. Nearly everyone in the audience of roughly 150 people raised a hand. In fact, all but three.
De-Stigmatizing Addiction And Supporting Workers
What can employers and industry stakeholders do? “The first thing is having the conversation,” said John Gaal, director of training and workforce development for the St. Louis-Kansas City Carpenters Regional Council. “It’s a tough subject to discuss but it’s not a matter of poor moral character. It’s a form of mental illness and we need to treat it that way.”
The Carpenters Council is addressing the issue in a number of ways aimed at raising awareness and providing support for workers and their family members who are struggling with opioid addiction.
In May, the council adjusted their drug testing policy. Formerly, policy dictated that a worker who didn’t pass a drug test was not eligible to work for a minimum of thirty days. The new policy gives workers the chance to return to work sooner, as long as they are following a treatment plan.
“We now know that isolation is an addict’s worst enemy,” said Gaal. “Sending someone home for thirty days with nothing to do isn’t the answer.”
The new drug-screening policy is more realistic, Gaal explained. “As long as they’re following their plan of treatment, they can return to work as soon as they’re able to test clean,” he said.
The council is also focusing on individual case management and resources to help struggling workers.
Both the Carpenter’s Union and the Laborer’s Union manage their own health care plans. Gaal said this offers an opportunity to provide focused case management for workers who have been prescribed opioids.
“We’ve got the ability to appropriately mine our data and follow up with our workers who have been prescribed opioids,” Gaal said. “And we can use that to educate people about the potential for addiction and provide support for individuals and families struggling with this.”
The Carpenters Council includes mental health courses in their safety training. Mentors in the apprenticeship program are required to complete eight hours of mental health “first aid”.
The Carpenters also participate in the Second Chance program, offering apprenticeships and a pathway to ex-offenders re-entering the workforce who have served their time and want to learn a trade.
“We can’t keep our heads in the sand about this issue. If we’re not talking about it, we’re not going to collectively solve it,” Gaal said.

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Broadcast Media Coverage

ABC 7 News

Dec 11, 2017 | KVII (ABC)

By Amarillo, TX

Rough Transcript: to date it feels like 42 when you walk out the door. you will be 42 degrees at 9 pm 28 in the morning. skies clear to mostly clear. for the next 7 to 10 days we are hoping for snow. or rain. we will talk about that in your sky cast in about 10 minutes or so. >>> car burglaries in amarillo are down. amarillo police say 22 armed -- car burglaries were down from last week. these burglaries were because something was left in the vehicle when the stuff was stolen. >>> potter county commissioners voted to join a lawsuit for opioids. they want to sue pharmaceutical companies. they say if money is rewarded, it helps payback cost the county has been at the house and mental health facilities. 25 texas counties joined in on this lawsuit. >>> in new mexico, as the shooter walked the halls of aztec high school last week, a janitor tried to stay close to the government in an effort to

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KAMR Local 4 News

Dec 11, 2017 | KAMR (NBC)

By Amarillo, TX

Rough Transcript: representative for district 61. (andy:) potter county has chosen tbe a part of fighting against the u-s' opioid crisis. today the potter county commissioner's court voted to retain two local law firms as well as two state firms to help in litigation against pharmaceutical companies they deemed responsible. potter county attorney scott brumley says we've seen this cris impact many parts of america, including right here on the high plains. "scott brumley / potter count attorney / "i think that there i recognition that our community has been impacted by the opiod crisis and that impact isn't solely in terms of things that are hard to quantify." (andy:) the lawsuit is directed at companies that used fraudulent marketing and sales of opioids which resulted in economic loss for potter county and it's people. (andy:) the 'me too' movement - is making its way into the white house. today - three women are speaking out - again - saying president

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Fox 14 News

Dec 11, 2017 | KCIT (FOX)

By Amarillo, TX

Rough Transcript: in litigation against pharmaceutical companies they deemed responsible. potter county attorney scott brumley says we've seen this cris impact many parts of america, including right here on the high plains. scott brumley / potter county attorney / "i think that there i recognition that our community has been impacted by the opiod crisis and that impact isn't solely in terms of things that are hard to quantify." (kelly:) the lawsuit is directed at companies that used fraudulent marketing and sales of opioids which resulted in economic loss for potter county and it's people. (meaghan:) amarillo police officer's association is helping foster kids in our area have a merry christmas. that's in today's heart of the high plains. (meaghan:) this afternoon, they made a donation of a thousand dollars to amarillo area casa to help purchase christmas gifts for those children. this year casa has 231 children who are in need of gifts. sargeant norm fisher amarillo

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