Opioid Litigation Daily Media Report - 3/14/18

Yurok Tribe, CA Suit

1. Tribe Says Opioid Makers Caused 'Public Health Crisis'

   Mar 14, 2018 | Law360

   By Danielle Nichole Smith
   
   
   A northern California tribe added another complaint to the slew of cases over the opioid epidemic Monday, slapping Purdue Pharma LP and other drug manufacturers and distributors with a suit accusing the companies of lying about the addictiveness of their drugs and hiding suspicious orders from regulators.
2. Yurok Tribe blames Big Pharma for opioid epidemic in lawsuit

   Mar 14, 2018 | Eureka Times Standard (CA)

   By Will Houston
   
   
   The Yurok Tribe announced Tuesday it has filed a federal lawsuit against 20 pharmaceutical companies claiming they systematically ignored negative health impacts of opioid prescriptions and caused a national “epidemic” of opioid addiction.
3. Yurok Tribes Files Federal Lawsuit Against Big Pharma Companies Over Opioid Epidemic

   Mar 13, 2018 | Last Coast Outpost (CA)

   By Ryan Burns
   
   
   The Yurok Tribe today filed a federal lawsuit against more than a dozen major pharmaceutical companies, alleging that they’re responsible for the nation’s deadly opioid epidemic.
4. NORTHERN CALIFORNIA TRIBE SUES DRUG COMPANIES FOR OPIOID EPIDEMIC

   Mar 14, 2018 | KDRV (CA)

   By Jamie Parfitt
   
   
   The Yurok Tribe of the Klamath River basin in California has filed suit in federal court against 20 major pharmaceutical companies. The case alleges corrupt practices by drug companies which contributed to widespread misuse of opioid painkillers in communities—such as the tribe itself.
5. Yurok Tribe Sues Drug Companies Over Opioid Epidemic

   Mar 14, 2018 | North Coast Journal (CA)

   By Kimberly Wear
   
   
   The Yurok Tribe has filed a federal lawsuit against 20 manufacturers and distributors of prescription opioids, alleging the companies are responsible for spreading the scourge of drug use on the reservation and across the country.

MDL

6. An Avalanche of Lawsuits Holds Hope for the Opioid Epidemic (Opinion)

   Mar 14, 2018 | JURIST

   By Lauren A. Rousseau
   
   
   According to the federal Centers for Disease Control, over 63,600 people died of drug overdose in the United States in 2016 - an average of 174 deaths per day. This was a 21% increase compared to 2015, and more than three times the number of such deaths in 1999. The annual number of overdose deaths has been steadily rising over the last fifteen years, leading many to refer to our current drug problem as an epidemic. And this epidemic has been driven largely by addiction to opioid drugs. In 2016, more than 42,000 overdose deaths, or 72%, were related to opioids, which includes prescription painkillers such as Vicodin, Lortab, Percocet, and OxyContin, as well as illicit drugs such as heroin and fentanyl. In October 2017, President Trump formally declared our country's drug problem a public health emergency.
7. Share, share, share, share your booty (Opinion)

   Mar 14, 2018 | West Virginia Record (WV)

   By Staff
   
   
   Picture the bank runs of the Depression. Financial institutions could accommodate the small number of nervous customers wanting to withdraw their savings and close their accounts, at first. As the number of withdrawals increased and panic set in, cash reserves rapidly dwindled until one by one the banks were shuttered.
8. Can Judge Dan Polster Get Big Pharma to Pony Up Billions for Its Role in the Opioid Crisis?

   Mar 14, 2018 | Clevescene (OH)

   By Daniel McGraw
   
   
   America will turn its drug-addicted eyes to Cleveland over the next year or two as the city becomes the capital of drug overdose law.
9. As Opioid Liability Claims Expand Across the Industry, Consider Your Insurance Coverage

   Mar 14, 2018 | Lexology

   By Tamara D. Bruno
   
   
   Regular readers of the Policyholder Pulse know that we often frame coverage issues with a lighthearted or (hopefully) humorous theme, but there’s nothing funny about the opioid crisis that continues to devastate lives and communities across the United States. The extent and impact of opioid addiction are being examined and explained by experts in the field, and we aren’t trying to tackle that subject on an insurance blog. Instead, this post outlines the expanding breadth of opioid liability claims at every level of the industry, and insurance coverage considerations raised by these claims.

Commentary and FYIs

10. Opioid Overprescribing Is Not a Myth (Opinion)

    Mar 13, 2018 | Politico Magazine

    By Jane Ballantyne, Gary Franklin And Andrew Kolodny
    
    
    From the beginning of the opioid crisis in the 1990s, when reports of addiction and overdoses involving OxyContin first surfaced from Appalachia and New England, spokespersons for the drug’s manufacturer, Purdue Pharma, insisted that problems were limited to drug abusers, not average patients. Prescribers and policymakers were told, misleadingly, that the development of addiction, even with long-term daily use, occurred in less than 1 percent of patients. By the early 2000s, when it became clear that opioid prescribing was soaring far beyond levels that could be clinically needed, and that rates of addiction and overdose death were rising in parallel, industry-funded opioid advocates continued to argue that addiction in patients was rare and that diversion from legitimate medical channels was the root of the problem. Policymakers were cautioned that efforts to reduce prescribing would unfairly penalize pain patients for the bad behavior of drug abusers.
11. Opioid Maker Funds Efforts To Fight Addiction: Is It ‘Blood Money’ Or Charity?

    Mar 14, 2018 | Kaiser Health News

    By Jenny Gold
    
    
    A program to give naloxone overdose-antidote kits and training to front-line officers. Funding for pill disposal boxes in pharmacies, clinics and police stations across North Carolina. A radio campaign in Connecticut warning of the dangers of opioid abuse. A new medicine to treat opioid-induced constipation.
12. Justice or Profit?: Lawyers scour Texas for opioid lawsuit clients (Opinion)

    Mar 14, 2018 | Texarkana Gazette (AR)

    By Staff
    
    
    Both Miller County, Ark., and Bowie County, Texas, are among the more than 100 states, counties and cities currently suing opioid manufacturers in federal court.
13. Overdose antidote availability doesn't always mean fewer deaths, study says

    Mar 14, 2018 | CNN

    By Susan Scutti
    
    
    Naloxone, a drug that rapidly reverses opioid overdose, has become more widely available as the United States struggles with an epidemic of drug abuse.

Southeast (GA, AL, NC, FL, WV)

14. Madison Co. to join suit against pharmaceuticals, distributors

    Mar 14, 2018 | Madison Journal Today (GA)

    By Staff
    
    
    Madison County is joining with other north Georgia counties to fight against opioid pharmaceuticals and distributors.
15. Decatur Co. votes to join opioid lawsuit

    Mar 13, 2018 | The Post Searchlight (GA)

    By Powell Cobb
    
    
    The Decatur County Board of Commissioners unanimously voted for the county to join a wave of lawsuits against opioid manufacturers and distributors.
16. Shelby County files lawsuit against opioid manufacturers

    Mar 14, 2018 | WBRC (AL)

    By Alan Collins
    
    
    Shelby County is taking steps to combat opioid abuse.
17. County considers suing drug companies

    Mar 14, 2018 | The Mountaineer (NC)

    By Vicki Hyatt
    
    
    The Haywood County Commissioners are mulling over the prospect of suing opioid manufacturers and distributors to recover costs related to the opioid epidemic sweeping the county.
18. Palm Beach County picks legal team to pursue opioid litigation

    Mar 13, 2018 | Sun Sentinel (FL)

    By Skyler Swisher
    
    
    Palm Beach County has joined a growing legal battle against drug companies to recoup the costs of fighting an opioid epidemic that is killing more than 1,000 people every year in South Florida.
19. Barbour, Taylor county commissions sue over opioid epidemic

    Mar 13, 2018 | The Exponent Telegram (WV)

    By Matt Harvey
    
    
    Two more West Virginia county commissions have sued multiple pharmaceutical companies, drugstores and the West Virginia Board of Pharmacy over West Virginia’s opioid crisis.

Midwest (IN)

20. West Lafayette files federal lawsuit against opioid makers

    Mar 13, 2018 | Purdue Exponent (IN)

    By Staff
    
    
    The city of West Lafayette formally joined a growing list of other Indiana municipalities suing more than a dozen drug companies this week for what it alleges was a calculated push of a class of dangerous drugs.

Southwest (OK)

21. Opioid manufacturers and distributors sued by Ponca Tribe

    Mar 14, 2018 | NewsOK (OK)

    By Randy Ellis
    
    
    The Ponca Tribe filed a federal lawsuit against 26 drug manufacturers and distributors Tuesday, accusing them of contributing to the tribe's opioid epidemic by fraudulently misrepresenting the risks and benefits of the addictive painkillers.

Broadcast Media Coverage

22. North Coast News at 11PM

    Mar 14, 2018 | Eureka, CA

    By KAEF (ABC)
    
    
    Video Link: http://app.criticalmention.com/app/#clip/view/33560572?token=edcfbe92-57d9-4710-8403-35bac4a7a702
23. Good Morning Utah

    Mar 14, 2018 | KTVX (ABC)

    By KTVX (ABC)
    
    
    Video Link: http://app.criticalmention.com/app/#clip/view/33560588?token=edcfbe92-57d9-4710-8403-35bac4a7a702
24. 12 News at 6am

    Mar 14, 2018 | Clarksburg, WV

    By WBOY (NBC)
    
    
    Video Link: http://app.criticalmention.com/app/#clip/view/33560594?token=edcfbe92-57d9-4710-8403-35bac4a7a702
25. Good Day Alabama 4:00am

    Mar 14, 2018 | Birmingham, AL

    By WBRC (Fox)
    
    
    Video Link: http://app.criticalmention.com/app/#clip/view/33560597?token=edcfbe92-57d9-4710-8403-35bac4a7a702
26. 18 News at Noon

    Mar 13, 2018 | Elmira, NY

    By WETM (NBC)
    
    
    Video Link: http://app.criticalmention.com/app/#clip/view/33560636?token=edcfbe92-57d9-4710-8403-35bac4a7a702

Yurok Tribe, CA Suit

1. Tribe Says Opioid Makers Caused 'Public Health Crisis'

   Mar 14, 2018 | Law360

   By Danielle Nichole Smith

   A northern California tribe added another complaint to the slew of cases over the opioid epidemic Monday, slapping Purdue Pharma LP and other drug manufacturers and distributors with a suit accusing the companies of lying about the addictiveness of their drugs and hiding suspicious orders from regulators.

   The Yurok Tribe said Purdue Pharma, Allergan PLC, Cardinal Health Inc., AmerisourceBergen Corp. and others worked together to make sure that opioids continued to be prescribed for chronic pain and did not take measures to prevent the diversion of their products to the illegal drug market in violation of the Racketeer Influenced and Corrupt Organizations Act.
   
   Abby Abinanti, the chief judge of the Yurok Tribal Court said the companies caused a lot of “anguish and death and destruction” and that scientific studies showed the epidemic should not have happened.
   
   “I think that the companies have really crossed a legal and moral line with what they’ve done, not just to us, but to a lot of people. I feel in many ways bad for them because this is on them now.” Abinanti said.
   
   The pharmaceutical companies falsely advertised their opioid drugs as treatments for chronic pain and downplayed the risks of serious addiction from their use, according to the complaint. The companies also did not report dubious drug orders, allowing opioids to be siphoned into the illicit drug market, the complaint said.
   
   The tribe also alleged that some of the companies collaborated through organizations like the Healthcare Distribution Alliance and Pain Care Forum, who are not parties in the suit, to lobby for legislation that would weaken the Drug Enforcement Administration.
   
   The Yurok Tribe said it is experiencing a "public health crisis" as a result of the high number of opioid prescriptions in the areas where its members reside and also cited statistics showing that Native Americans are more adversely affected by the epidemic. The tribe is seeking compensation for its expenses allegedly caused by the opioid epidemic.
   
   The pharmaceutical companies are also currently facing multidistrict litigation in Ohio over the opioid epidemic. Representatives for several of the pharmaceutical companies provided Law360 with their general responses to opioid litigation when asked for comment.
   
   Allergan’s statement said it was “important to put into perspective Allergan’s role regarding opioids” and that its three legacy opioid drugs only accounted for .04 percent of all opioid prescriptions in the U.S. in 2017. Purdue’s statement said the percentage of its opioid prescriptions was “less than 2 percent of the total opioid prescriptions” and mentioned measures the company has taken to counter opioid abuse.
   
   A representative for the Health Distribution Alliance, whose members include defendants McKesson Corp., Cardinal Health and AmerisourceBergen, provided a statement from its senior vice president John Parker, challenging the idea that distributors were responsible for the number of opioid prescriptions and arguing that lawsuits should focus on the root causes for the epidemic.
   
   A statement from Teva Pharmaceutical Industries Ltd. said the company was taking a “multi-faceted approach” to the issue of opioid addiction stemming from prescription drugs, and Janssen Pharmaceuticals Inc.'s statement said the allegations against it were “baseless and unsubstantiated.”
   
   McKesson’s statement said the company has reported controlled substance orders to the DEA for decades, including hundreds of thousands of suspicious orders it did not fill in the past year.
   
   A representative for Endo Pharmaceuticals Inc. said the company does not comment on current litigation. The remaining parties were not able to provide comment before the time of publication.
   
   The tribe is represented by Dan Drachler, Robert S. Schachter and Hillary Sobel of Schachter & Zwerling LLP and Elizabeth J. Cabraser, Eric B. Fastiff, Paulina Do Amaral and Mark P. Chalos of Lieff Cabraser Heimann & Bernstein LLP.
   
   Counsel information for the defendants was not immediately available.
   
   The case is Yurok Tribe v. Purdue Pharma L.P. et al, case number 3:18-cv-01566 in the U.S. District for the Northern District of California.
   

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2. Yurok Tribe blames Big Pharma for opioid epidemic in lawsuit

   Mar 14, 2018 | Eureka Times Standard (CA)

   By Will Houston

   The Yurok Tribe announced Tuesday it has filed a federal lawsuit against 20 pharmaceutical companies claiming they systematically ignored negative health impacts of opioid prescriptions and caused a national “epidemic” of opioid addiction.

   The tribe alleges the manufacturing and distribution companies violated the 1970 Racketeer Influenced and Corrupt Organizations Act, commonly known as the RICO Act, by concealing important facts about the dangers of opioids. The lawsuit also alleges false advertising, public nuisance and participating in unlawful or fraudulent business practices.

   “Without these pharmaceutical manufacturers and wholesalers, the widespread abuse of prescription pain pills on tribal lands and across the entire U.S. would never have reached the terrifying level it is at today,” the tribe’s General Counsel and tribal member Amy Cordalis said in a Tuesday statement.

   A California Department of Public Health report in late 2017 found Humboldt County had the second highest opioid overdose rate in the state and found there were more prescriptions for opioid medication than there were county residents.

   “The only difference between these companies and drug cartels is the fact that legal purveyors of prescription opioids have protection from law enforcement and seemingly unlimited funds to market and distribute to the masses their highly addictive drugs,” Cordalis continued. “There is not a single Yurok family that has not either directly or indirectly experienced the horrors of opiate addiction.”

   The vice president of a pharmaceutical distribution trade association, the Healthcare Distribution Alliance, said in a statement that “those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”

   “The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders,” John Parker said in a statement sent to the Times-Standard on Tuesday. “Given our role, the idea that distributors are responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and is regulated.”

   LAWSUIT DEMANDS

   The complaint filed on Monday in the U.S. District Court of Northern California in San Francisco seeks damages to be paid to the tribe for costs of providing medical care for patients suffering from opioid-related addictions or disease including overdoses and deaths; costs for treatment of infants born with opioid-related medical conditions; costs for providing culturally-informed treatment, counseling, detox and rehabilitation services; costs for providing care for children whose parents suffer from opioid-related disabilities or “incapacitation;” and costs associated with law enforcement and public safety relating to the “opioid epidemic.”

   The lawsuit also calls for the court to order the companies to reduce and stop its “wrongful conduct” of publishing “false and misleading materials.”

   The tribe is being represented by the Zwerling, Schachter & Zwerling law firm in Seattle, and the Lieff, Cabraser, Heimann & Bernstein law firm in San Francisco, according to the lawsuit.

   PHARMA RESPONDS

   The Times-Standard reached out to all of the companies named in the tribe’s lawsuit, of which some have provided responses either directly to the allegations or about the opioid addiction in general.

   AmerisourceBergen’s Vice President of Communications Gabe Weissman said opioid prescriptions make up less than two percent of the sales for their distribution company. He said they are committed to collaborating with stakeholders on ways to combat opioid abuse.

   “We are dedicated to doing our part as a distributor to mitigate the diversion of these drugs without interfering with clinical decisions made by doctors, who interact directly with patients and decide what treatments are most appropriate for their care,” Weissman wrote in an email.

   “Beyond our reporting and immediate halting of tens of thousands of potentially suspicious orders,” he continued, “we refuse service to customers we deem as a diversion risk and provide daily reports to the DEA that detail the quantity, type, and the receiving pharmacy of every single order of these products that we distribute.”

   A statement by Teva Pharmaceutical Industries Inc. spokesperson Kaelan Hollon said the company is committed to appropriate use of opioid medicines and recognizes the “critical public health issues” impacting the U.S.

   “To that end, we take a multi-faceted approach to this complex issue; independently ceasing promotion of all opioid products, working to educate communities and health care providers on appropriate medicine use and prescribing, and complying with all relevant federal and state regulations regarding these medicines,” Hollon wrote.

   A statement from the McKesson Corporation provided by company spokeswoman Kristin Chasen said the company was taking similar actions. The statement says that each participant in the supply chain from doctors to patients “must play a role in combatting this crisis.”

   “In the past year alone, we reported hundreds of thousands of suspicious orders to the DEA and did not fulfill those orders,” the statement reads. “As a distributor, McKesson only distributes opioid medications to pharmacies that are DEA-registered and state-licensed, and we only distribute in response to orders that pharmacies place – we do not drive demand.”

   Endo Pharmaceuticals Inc. Corporate Affairs Executive Director Heather Lubeski said it is company policy not to comment on current litigation.

   The Cardinal Health distribution company deferred comment to their representative Clare Krusing of the distributor trade association, the Healthcare Distribution Alliance.

   Krusing said that she cannot speak for individual companies, but said there are many “misperceptions around the industry’s role in the opioid epidemic.”

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3. Yurok Tribes Files Federal Lawsuit Against Big Pharma Companies Over Opioid Epidemic

   Mar 13, 2018 | Last Coast Outpost (CA)

   By Ryan Burns

   The Yurok Tribe today filed a federal lawsuit against more than a dozen major pharmaceutical companies, alleging that they’re responsible for the nation’s deadly opioid epidemic.

   In the complaint, which you can read in full by clicking the link at the bottom of this post, the tribe says these pharmaceutical giants, including Purdue Pharma (manufacturer of OxyContin), Ortho-McNeil-Janssen and Johnson & Johnson, “systematically and repeatedly disregarded the health and safety of the public” in order to maximize profits from their addictive prescription painkillers.

   The Yurok Tribe isn’t the first government agency to take aim at Big Pharma over opioids. Attorneys general in at least three states have filed similar suits, as have four counties in New York and two in California. These cases have parallels to suits filed against Big Tobacco in the 1990s, which eventually resulted in the largest civil-litigation settlement agreement in U.S. history.

   The suit notes that, as the Outpost has reported, Humboldt County has been hit particularly hard by the opioid epidemic. Calling our region “one of America’s first and hardest hit regions by the opioid crisis,” the Yurok’s federal complaint notes that “Humboldt County has had crisis-level overdose rates for over a decade.”

   The tribe is demanding a jury trial and is pursuing a RICO case against the pharmaceutical giants. RICO, which stands for the Racketeer Influenced and Corrupt Organizations Act, has been used to tackle high-profile organized crime organizations including the Catholic Church, the Hells Angels and the Gambino crime family. RICO cases allow for criminal and civil penalties against organizations found guilty of racketeering, though they’re often difficult to prove.

   In the press release below the tribe says today’s filing is the first step toward a jury trial, “where the corrupt actions of the accused will be presented for the world to see.”

   From the Yurok Tribe:
   

   The Yurok Tribe filed in federal court a RICO [Racketeer Influenced and Corrupt Organizations Act] case against the pharmaceutical giants that are alleged to be responsible for the surging opioid epidemic in the United States and on the Yurok Reservation.

   “Without these pharmaceutical manufacturers and wholesalers, the widespread abuse of prescription pain pills on tribal lands and across the entire U.S. would never have reached the terrifying level it is at today,” said Amy Cordalis, the Yurok Tribe’s General Counsel and Yurok Tribal member. “The only difference between these companies and drug cartels is the fact that legal purveyors of prescription opioids have protection from law enforcement and seemingly unlimited funds to market and distribute to the masses their highly addictive drugs. There is not a single Yurok family that has not either directly or indirectly experienced the horrors of opiate addiction.”

   The complaint, filed on behalf of the Tribe by Zwerling, Schachter & Zwerling, LLP and Lieff Cabraser Heimann & Bernstein, LLP in the United States District Court for the Northern District of California, alleges that 20 defendants violated the 1970 Racketeer Influenced and Corrupt Organizations Act (RICO). The defendants, ranging from Purdue Pharma to Johnson & Johnson, include both manufacturers and distributors of opiate-based drugs. The complaint alleges that defendants concealed important facts about the dangers of opioids and the costs to communities, such as that of the Yurok Tribe.  Also contained in the complaint are charges of false advertising, public nuisance and participating in unlawful, unfair, and/or fraudulent business practices. The Tribe decided to pursue the case after Yurok Chief Justice Abby Abinanti, a longtime magistrate and Yurok Tribal member, first identified opiate addiction as a significant health and safety issue on the reservation and she has largely spearheaded this effort to hold the defendants accountable.

   The Yurok Reservation, located in one of only a handful of places where the U.S. opioid crisis initially took root, occupies land in rural Northern California’s Humboldt and Del Norte Counties. Humboldt County, one of the first counties in the entire nation to see lawfully produced prescription painkillers diverted for clandestine purposes, has had crisis-level overdose rates for over a decade. Much of this so-called medicine has made it to the reservation, which is evidenced by the number of inquiries the Tribe receives from those looking for opioid addiction treatment.

   “For too long, the Yurok Tribe has been forced to contend with the deadly aftermath of the proliferation of opioids in society,” according to the complaint. “Opioid manufacturing and distributing companies systematically and repeatedly disregarded the health and safety of the public, including the Yurok Tribe.”

   In the United States, 91 people die every day from opioid overdose and in 2016 opiates killed 42,000 US citizens, including disproportionately high numbers of Native Americans, according to the US Centers for Disease Control and Prevention. In March 2, 2018, the CDCP announced the results of a yearlong study, which showed that commonly prescribed opioids produced less pain relief than over-the-counter, non-opioid drugs in patients suffering from serious back aches as well as hip or knee arthritis.

   This filing represents the first step toward a jury trial in federal court, where the corrupt actions of the accused will be presented for the world to see.

   “It is clear that we as a nation have been sold a bill of goods as it relates to opiate painkillers. These drugs have caused so much unnecessary heartache as well as the untimely deaths of many Native American and non-Indian people. The companies that produce, market and distribute them need to be held accountable,” concluded Cordalis. 

   The Yurok Tribe is the largest federally recognized Indian tribe in California and has a reservation that straddles the Lower Klamath River, extending for one mile on each side of the river, from its entry into the Pacific Ocean to approximately 45 miles upriver to the confluence with the Trinity River. The Tribe’s major initiatives include: natural resources management, fisheries protection, watershed restoration, dam removal, condor reintroduction, cultural revitalization, language preservation and land acquisition.

   # # #

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4. NORTHERN CALIFORNIA TRIBE SUES DRUG COMPANIES FOR OPIOID EPIDEMIC

   Mar 14, 2018 | KDRV (CA)

   By Jamie Parfitt

   The Yurok Tribe of the Klamath River basin in California has filed suit in federal court against 20 major pharmaceutical companies. The case alleges corrupt practices by drug companies which contributed to widespread misuse of opioid painkillers in communities—such as the tribe itself.
   

   According to the lawsuit, the 20 defendants violated a 1970 law known as the Racketeer Influenced and Corrupt Organizations Act (RICO). The tribe claims that drug companies systematically concealed the dangers of opioid drugs—engaging in false advertising, public nuisance, and unlawful, unfair, and fraudulent business practices.

   The defendants include Purdue Pharma and Johnson & Johnson, among other notable drug manufacturers and distributors.

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5. Yurok Tribe Sues Drug Companies Over Opioid Epidemic

   Mar 14, 2018 | North Coast Journal (CA)

   By Kimberly Wear

   The Yurok Tribe has filed a federal lawsuit against 20 manufacturers and distributors of prescription opioids, alleging the companies are responsible for spreading the scourge of drug use on the reservation and across the country. 

   “The only difference between these companies and drug cartels is the fact that legal purveyors of prescription opioids have protection from law enforcement and seemingly unlimited funds to market and distribute to the masses their highly addictive drugs,” Amy Cordalis, the Yurok Tribe’s general counsel who is also a tribal member, said in a release. “There is not a single Yurok family that has not either directly or indirectly experienced the horrors of opiate addiction.”

    According to the release, the Yurok reservation is “one of only a handful of places where the U.S. opioid crisis initially took root.”

   Humboldt County has more opioid prescriptions than residents and a correspondingly high rate of overdose deaths — most involving methamphetamine or opiate intoxication — with 32 recorded in 2017, which was three times the state per-capita average and almost twice that of the nation.

    In 2016, 26 people died of opioid-related overdoses in Humboldt County — an average of one death every 14 days.

    “It is clear that we as a nation have been sold a bill of goods as it relates to opiate painkillers. These drugs have caused so much unnecessary heartache as well as the untimely deaths of many Native American and non-Indian people. The companies that produce, market and distribute them need to be held accountable,” Cordalis said.

    Read the full release from the Yurok Tribe below:

    The Yurok Tribe filed in federal court a RICO case against the pharmaceutical giants that are alleged to be responsible for the surging opioid epidemic in the United States and on the Yurok Reservation.

    “Without these pharmaceutical manufacturers and wholesalers, the widespread abuse of prescription pain pills on tribal lands and across the entire US would never have reached the terrifying level it is at today,” said Amy Cordalis, the Yurok Tribe’s General Counsel and Yurok Tribal member. “The only difference between these companies and drug cartels is the fact that legal purveyors of prescription opioids have protection from law enforcement and seemingly unlimited funds to market and distribute to the masses their highly addictive drugs. There is not a single Yurok family that has not either directly or indirectly experienced the horrors of opiate addiction.”

    The complaint, filed on behalf of the Tribe by Zwerling, Schachter & Zwerling, LLP and Lieff Cabraser Heimann & Bernstein, LLP in the United States District Court for the Northern District of California, alleges that 20 defendants violated the 1970 Racketeer Influenced and Corrupt Organizations Act (RICO). The defendants, ranging from Purdue Pharma to Johnson & Johnson, include both manufacturers and distributors of opiate-based drugs.

    The complaint alleges that defendants concealed important facts about the dangers of opioids and the costs to communities, such as that of the Yurok Tribe. Also contained in the complaint are charges of false advertising, public nuisance and participating in unlawful, unfair, and/or fraudulent business practices. The Tribe decided to pursue the case after Yurok Chief Justice Abby Abinanti, a longtime magistrate and Yurok Tribal member, first identified opiate addiction as a significant health and safety issue on the reservation and she has largely spearheaded this effort to hold the defendants accountable.

    The Yurok Reservation, located in one of only a handful of places where the US opioid crisis initially took root, occupies land in rural Northern California’s Humboldt and Del Norte Counties. Humboldt County, one of the first counties in the entire nation to see lawfully produced prescription painkillers diverted for clandestine purposes, has had crisis-level overdose rates for over a decade. Much of this so-called medicine has made it to the reservation, which is evidenced by the number of inquiries the Tribe receives from those looking for opioid addiction treatment.

    “For too long, the Yurok Tribe has been forced to contend with the deadly aftermath of the proliferation of opioids in society,” according to the complaint. “Opioid manufacturing and distributing companies systematically and repeatedly disregarded the health and safety of the public, including the Yurok Tribe.”

    In the United States, 91 people die every day from opioid overdose and in 2016 opiates killed 42,000 US citizens, including disproportionately high numbers of Native Americans, according to the US Centers for Disease Control and Prevention. In March 2, 2018, the CDCP announced the results of a yearlong study, which showed that commonly prescribed opioids produced less pain relief than over-the-counter, non-opioid drugs in patients suffering from serious back aches as well as hip or knee arthritis.

    This filing represents the first step toward a jury trial in federal court, where the corrupt actions of the accused will be presented for the world to see.

    “It is clear that we as a nation have been sold a bill of goods as it relates to opiate painkillers. These drugs have caused so much unnecessary heartache as well as the untimely deaths of many Native American and non-Indian people. The companies that produce, market and distribute them need to be held accountable,” concluded Cordalis.

    The Yurok Tribe is the largest federally recognized Indian tribe in California and has a reservation that straddles the Lower Klamath River, extending for one mile on each side of the river, from its entry into the Pacific Ocean to approximately 45 miles upriver to the confluence with the Trinity River. The Tribe’s major initiatives include: natural resources management, fisheries protection, watershed restoration, dam removal, condor reintroduction, cultural revitalization, language preservation and land acquisition.

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MDL

6. An Avalanche of Lawsuits Holds Hope for the Opioid Epidemic (Opinion)

   Mar 14, 2018 | JURIST

   By Lauren A. Rousseau

   According to the federal Centers for Disease Control, over 63,600 people died of drug overdose in the United States in 2016 - an average of 174 deaths per day. This was a 21% increase compared to 2015, and more than three times the number of such deaths in 1999. The annual number of overdose deaths has been steadily rising over the last fifteen years, leading many to refer to our current drug problem as an epidemic. And this epidemic has been driven largely by addiction to opioid drugs. In 2016, more than 42,000 overdose deaths, or 72%, were related to opioids, which includes prescription painkillers such as Vicodin, Lortab, Percocet, and OxyContin, as well as illicit drugs such as heroin and fentanyl. In October 2017, President Trump formally declared our country's drug problem a public health emergency.

   Much media attention has been given to the role pharmaceutical companies have played in creating the opioid epidemic. In the mid-1990s, the medical community's conclusion that pain was undertreated converged with Purdue Pharma's introduction of its new, extended-release opioid drug OxyContin, setting the stage for a sea change in how opioids were used and prescribed. Prior to this, opioids had been viewed as dangerously addictive and were prescribed only under limited circumstances, but Purdue claimed that OxyContin was virtually non-addictive when prescribed for pain and aggressively marketed it for long-term use. Its marketing strategy was wildly successful; sales of OxyContin exploded from $45 million in 1996 to $3 billion in 2012. Other opioid drug manufacturers jumped on the bandwagon, with the result that opioid prescriptions in this country nearly quadrupled from 1999 to 2010. By 2012, more than 259 million opioid prescriptions were written - enough for every American adult to have his or her own bottle of pills.

   We are all now painfully aware that opioid drugs are extremely addictive. Opioid overdose deaths have risen in tandem with the increase in opioid prescriptions. Prescription pills also served as a gateway to heroin use. Heroin is a stronger and cheaper opioid, and once a person becomes addicted to prescription pills, cost and difficulty obtaining pills often drive the person to heroin. According to the American Society of Addiction Medicine, four out of five heroin users start with prescription pills.

   The drug epidemic has been extremely costly to our country, in terms of both human life and dollars. Over 500,000 people have lost their lives since 2000 due to drug overdose, and it is estimated that another 500,000 will die from this cause by 2027. The cost to our society, in terms of lost wages, productivity, and tax revenue, as well as increased spending on health care, social services, education, and criminal justice, is estimated to have exceeded $1 trillion from 2001 to 2017. Increasingly, state and local governments are looking to the pharmaceutical industry to cover these costs.

   Purdue Pharma has been repeatedly sued based on its misrepresentations concerning the addictive nature of its opioid drugs. The company pled guilty in 2007 to criminal charges of misbranding OxyContin with the intent to defraud and mislead the public, and paid $635 million in fees and fines. Other drug companies have also paid millions of dollars in civil penalties and fines in connection with their opioid drugs.

   In September 2017, the attorneys general of 41 states announced that they were banding together to investigate opioid manufacturers and distributors to determine their role in creating the opioid epidemic. And in the past year and a half, hundreds of lawsuits have been filed by cities, counties, and states in both state and federal courts against opioid drug manufacturers and distributors, alleging misleading marketing and failure to monitor, detect, investigate, and report suspicious orders of opioid drugs.

   In December 2017, 64 opioid lawsuits filed in federal courts in Alabama, California, Illinois, Kentucky, Ohio, Washington, and West Virginia were consolidated by the federal Judicial Panel on Multidistrict Litigation and transferred to the Northern District of Ohio under Judge Dan Polster. Since then, the litigation has grown to include more than 250 lawsuits, and is known as the National Prescription Opiate Litigation, MDL #2804. Ohio was chosen as the venue because it has the second highest overdose death rate in the nation (second only to West Virginia), is geographically central and accessible to the parties, and is home to one of the largest wholesale drug distributors.

   The opioid litigation has been compared to the tobacco litigation of the 1990s, which resulted in the largest civil settlement in our nation's history. In those cases, 46 state attorneys general claimed that the tobacco companies were liable for the costs of treating smoking-related illnesses. The settlement exceeded $200 billion, with the companies agreeing to make annual payments to the states to fund smoking prevention campaigns and other health programs. Unfortunately, much of that settlement money has been diverted by the states for purposes unrelated to smoking.

   The opioid litigation plaintiffs face challenges that the tobacco plaintiffs did not. In the tobacco cases, smokers weren't misusing the products, but got sick anyway; with opioids, users who develop addiction inevitably take more of the drug than is prescribed, and often engage in criminal behavior such as doctor-shopping, forging prescriptions, or stealing pills. These behaviors make it harder to hold pharmaceutical companies liable for the consequences of opioid use. Historically, courts have laid blame for drug misuse on the individual user, not on pharmaceutical companies. Moreover, in the tobacco cases, the companies were marketing directly to consumers, making it easier to link tobacco use to the companies' actions; with opioids, pharmaceutical companies directed their marketing campaigns at doctors, who then prescribed the drugs to their patients. The companies can point to doctors as an intervening cause, alleging that they overprescribed and should have recognized signs of addiction in their patients.

   Despite the challenges, it is clear that the pharmaceutical industry is facing significant potential liability. Judge Polster has indicated that he would like to see these cases resolved through settlement before trial. In February, he invited representatives of all the parties to begin settlement discussions, and included representatives of state court opioid lawsuits, the state attorneys general who banded together to investigate the industry, the federal Drug Enforcement Agency, the Food and Drug Administration, and insurance companies. By all appearances, Judge Polster is working to craft a global resolution designed to turn the tide on the opioid crisis.

   However the lawsuits are resolved, they will surely have a positive impact on health policy and community attitudes towards addiction. The hundreds of filings publicly demonstrate the pervasiveness of the disease, showing that it hits all communities, all socioeconomic classes, and all ages and ethnicities. This helps to reduce the stigma associated with addiction that so often is a barrier to treatment and recovery. The lawsuits have shown a spotlight on the deceptive marketing practices of the pharmaceutical industry, to the benefit of both doctors and patients, many of whom will now take more care in how they deal with medications. The lawsuits also provide support for government regulation that is clearly needed to curb excessive prescribing by doctors, misleading marketing behaviors of pharmaceutical companies, and irresponsible drug distribution. In a possible harbinger of things to come, Purdue Pharma announced on February 10th that it will voluntarily stop marketing its opioid drugs to doctors.

   A large monetary settlement of these cases could make a significant difference in reversing the upward trend in overdose deaths and addiction. There is a serious shortage of treatment beds, facilities, and trained personnel to treat addiction, and funding could alleviate these problems. Money is also needed for prevention efforts in schools, education and awareness campaigns, health care reimbursement costs, addiction treatment in the jails, first responder training, and supplies of the overdose reversal drug naloxone. Taking a lesson from the failures of the tobacco settlement, any opioid litigation settlement should include provisions to ensure that states are using the money for its intended purpose, and not diverting it to other uses.

   Concern has been raised by some that the pendulum may swing too far, and that patients with legitimate pain may be denied needed medication. This is a legitimate issue. However, scientific studies have demonstrated that long-term opioid therapy for chronic pain is not as effective as once thought, and that non-opioid pain relievers can provide comparable relief. Furthermore, the liability and addiction issues surrounding opioid drugs are spurring research into alternative pain therapies that are safer and equally effective.

   In conclusion, the avalanche of lawsuits filed by cities, counties, and states against the pharmaceutical industry holds promise as a significant step forward in combatting the opioid epidemic. Lives literally hang in the balance as Judge Polster works with the parties to craft a settlement that could finally turn the tide on this scourge that is devastating our nation.

   Lauren A. Rousseau is a professor of law at Western Michigan University Thomas M. Cooley Law School. She is President of the Northwest Wayne County Chapter of Families Against Narcotics, and has spoken and written extensively on the subject of addiction and the opioid epidemic. In 2016, she was honored as one of Michigan Lawyers Weekly's 2016 Women in the Law in recognition of the work she has done in the area of addiction treatment, education, and advocacy.

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7. Share, share, share, share your booty (Opinion)

   Mar 14, 2018 | West Virginia Record (WV)

   By Staff

   Picture the bank runs of the Depression. Financial institutions could accommodate the small number of nervous customers wanting to withdraw their savings and close their accounts, at first. As the number of withdrawals increased and panic set in, cash reserves rapidly dwindled until one by one the banks were shuttered.

   Picture immigrants in Northern Africa hoping to make their way to Europe, piling on precarious crafts never meant for such numbers, and never getting to their destination as their overpopulated boats went under in the Mediterranean.

   Picture any kind of stampede and you'll have an apt image of the current opioid litigation epidemic. More and more would-be passengers are trying to board the mass-tort gravy train and the ones already on board don't like the sight of the latecomers, because they're fearful that the engine won't be able to handle the additional weight and will break down and leave them all with nothing.

   You can feel sorry for those who lost their lives in the sea or their life savings in the bank run, but the vultures and hyenas circling the opioid manufacturers and distributors, hoping to feast on their carcasses, do not arouse much sympathy. In fact, you might look forward to them getting the just rewards of greed and selfishness.

   At a recent conference in San Francisco, a pack of plaintiff lawyers fretted over how difficult it will be to satisfy all the stakeholders and still make a killing for themselves as contingency-fee counsel for counties and towns.

   The problem is, they're already competing with state attorneys general for a piece of a finite pie, and now the federal government is maneuvering to get in on the action – ostensibly with the hope of  recovering billions of dollars in Medicare and Medicaid expenditures associated with opiate addiction.

   Plaintiff attorneys who attended the San Francisco conference might prefer to shaft the state and federal governments and keep the lion's share for themselves and their municipal clients, but they know that’s unlikely. 

   Maybe another bunch of lawsuits on who has first dibs to the tribute would be helpful?

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8. Can Judge Dan Polster Get Big Pharma to Pony Up Billions for Its Role in the Opioid Crisis?

   Mar 14, 2018 | Clevescene (OH)

   By Daniel McGraw

   America will turn its drug-addicted eyes to Cleveland over the next year or two as the city becomes the capital of drug overdose law.

   What has happened is pretty simple if we take the lawyering talk out of it. Cities, counties and states have gotten pissed off in recent years with skyrocketing prescription pain medication usage and its ensuing public health crisis, thanks to overdoses from prescribed and illegal opioids, which they've had to clean up, literally, figuratively and financially. That includes more crime, ambulances, processing dead bodies that pile up so quickly and in such great numbers that some county coroners have had to call in mobile trailers to accommodate the cadavers, more foster care, health care, and it goes on and on.

   They asked the federal government for money to help, asked the FDA to restrict pain pills like OxyContin from being passed out like candy, asked the pharmaceutical companies to quit being so greedy, and even asked medical schools to teach their doctors not to prescribe so many.

   No one listened. And the stats kept getting worse.

   The country now averages 52,000 overdose deaths a year. That's six an hour. If you are keeping score for Ohio, about 13 will die today from an OD. In Cuyahoga County, about two a day. For further perspective, those 52,000 who died from opioid-related overdoses nationally in 2016 were more than the deaths from breast cancer (40,000), car crashes (38,000), suicides (32,000), and homicides (17,000) that year.

   So they all sued. Well, most of them. Nearly 400 cities, counties, states and Native American tribes (at last count) have filed lawsuits against opioid pill manufacturers and the companies that distribute them to pharmacies alleging the companies up and down the supply chain willfully produced, marketed and shipped astounding quantities of what they knew to be highly addictive drugs.

   Those lawsuits might be put to rest at 801 Superior Ave. on the 18th floor of the Carl B. Stokes Federal Courthouse.

   In December 2017, the U.S court system brought all those cases together in what's known as a Multi-District Litigation (MDL). Basically, the process gathers a whole bunch of similar cases and streamlines them through one court after which they'd all share rulings — what documents the defendants need to provide, who must sit for depositions, rulings on various motions and evidence — and then the cases return to the state where they were initially filed for actual trial.

   The judicial panel chose Cleveland, and federal judge Dan Polster, for the MDL, for a variety of reasons. Cleveland has been among the hardest hit areas of the country, for starters, and many of the cases filed come from neighboring states.

   Kicking the cases back to trial is one option for how this can work. In reality, judges in MDL cases have all sorts of latitude and leeway, and some figure they can take the bull by the horns, tell the high-priced lawyers to go sit in a corner, and craft some master settlement for all the cases at once. That's what's happening in Cleveland with Polster, a Shaker Heights native and Clinton appointee, who has indicated he wants to be the kind of MDL judge who does more than play legal traffic cop. That much was clear from the start, and perhaps not surprising given Polster's reputation and advocacy for settlements in lieu of expensive and lengthy trials.

   At the first meeting of the major players in his courtroom on Jan. 9, when Polster told them to immediately begin getting ready for settlement talks, he said a pretty amazing thing to the lawyers involved, indicating that everyone's to blame, and that any settlement had to go beyond dollars and cents to address real, viable solutions to a problem that is decimating the American population.

   "This is not a traditional [case]," he said. "What's happening in our country with the opioid crisis is present and ongoing. I did a little math. Since we're losing more than 50,000 of our citizens every year, about 150 Americans are going to die today, just today, while we're meeting.

   "And in my humble opinion, everyone shares some of the responsibility, and no one has done enough to abate it. That includes the manufacturers, the distributors, the pharmacies, the doctors, the federal government and state government, local governments, hospitals, third-party payers, and individuals. The federal court is probably the least likely branch of government to try and tackle this, but candidly, the other branches of government, federal and state, have punted. So it's here.

   "So I don't think anyone in the country is interested in a whole lot of finger-pointing at this point, and I'm not either. Just dramatically reduce the quantity, and make sure that the pills that are manufactured and distributed go to the right people and no one else, and that there be an effective system in place to monitor the delivery and distribution. Because sadly, every day more and more people are being addicted, and they need treatment."

   That was not a traffic-cop judge speaking. Indeed, he quickly drew criticisms from lawyers involved — The New York Times, while shadowing him for a day, overheard counsel calling him a "grandstander" and "Pollyanna" — and from the legal community at-large keenly following the proceedings. One Yale law professor remarked, "To say his goals are ambitious would be an enormous understatement."

   Polster, 66, who the Times noted had a hasty lunch of a hard-boiled egg and a tangerine that day, had no qualms concurring with the sentiment. "I think that's a fair assessment," he told the paper. "But I won't fault myself for attempting this."

   "This" is presiding over a case which represents the interests of the medical community, political policy, deaths that are hitting every age and gender and race in every state, big pharma power, and multi-billions of dollars that could be dispersed to little towns around the country.

   And he might have to settle this by telling millions of Americans that they can't have as many pain pills as they used to, that pain is more of symptom and not a disease as some have pushed.

   No one knows how this herculean, if not quixotic, journey might turn out, but no judge in recent times has ever really tried to handle something this monstrous. This is a historic crisis, and it's happened on our collective watch.

   "I read recently that we've managed in the last two years, because of the opioid problem, to do what our country has not done in 50 years, which is — for two consecutive years — to reduce, lower the average life expectancy of Americans," Polster said at the January hearing. "And if we don't do something in 2018, we'll have accomplished it for three years in a row, which we haven't done since the flu epidemic 100 years ago wiped out 10 percent of our population. And this is 100-percent manmade. Now, I'm pretty ashamed that this has occurred while I've been around. So I think we all should be."

   Michael Moffitt is a Harvard Law School professor specializing in negotiations, dispute resolution and mediation in civil cases like this. He's from Wadsworth and lived in Avon Lake some years ago while clerking for federal judge Ann Aldrich in Cleveland.

   When asked how Polster might act in a case like this, he did what most do, throwing up his hands and declaring, "Who knows?" But Moffitt does see something different happening.

   "For about a decade, I used to teach civil procedure: a required, introductory course for all first-year law students, aimed at helping them to understand the basic rules, concepts, and structures of modern litigation," Moffitt said. "Inevitably, at some point during the year, a student would raise her hand and ask, 'Can a federal district court judge ... ,' and I would cut her off, responding, 'Yes.' The class would laugh, and I would explain that it's hard to finish that question in a way that would make me wrong.

   "I know that reading judicial tea leaves is something of a sport, both among academics and among members of the practicing bar. My admittedly uncomplicated, perhaps unsophisticated, inclination in this case would be to believe that Judge Polster means what he said on Jan. 9.

   "The prominence of discretion, the opportunity for creative problem solving, and the lack of narrow constraints on the judge or on the parties are precisely what causes some to be nervous and some to be optimistic," Moffitt continued. "But regardless of one's initial reaction to the conversations that are beginning in Ohio, we should all be curious, because we are all likely to be affected by what emerges — or doesn't emerge."

   Polster's background would lead many to believe he will be trying to run down a path few would try. A native and current resident of Shaker Heights, and a member of the Jewish congregation Shaarey Tikvah in Beachwood and Park Synagogue in Cleveland Heights and Pepper Pike, he often cites the Old Testament Deuteronomy passage, "Justice, justice, you shall pursue," as influencing how he manages his court.

   He is keeping a low profile in this case, and has instructed the lawyers and politicians involved in this case not to divulge any settlement discussions to the media. He himself is abiding by those restrictions. But reading the tea leaves of his Cleveland upbringing, there's enough of a varied cultural and political mix to make "creative problem solving" a possibility for him.

   He grew up in the Ludlow neighborhood in Cleveland in the 1950s, just off Shaker Square, and his parents helped form a neighborhood association that discouraged the "redlining" and "blockbusting" that was segregating that neighborhood.

   In a 2016 interview with The Federalist Lawyer about his parents' action, Polster said, "Ordinary people can do extraordinary, heroic things if they recognize the opportunity and realize, 'This is my time to do something significant, I'm not going to take a pass.' Usually people take a pass."

   In grade school, his Little League baseball coach was Cleveland Indians' third baseman Al Rosen (whose son was on the team). Rosen, "The Hebrew Hammer" who tended the hot corner for the Indians for 10 years and won an Al MVP in 1953, tried to teach the sixth-grader how to hit a curveball. Polster couldn't figure the curve out, went home one day, threw his glove on the floor, and told his parents, "I guess I gotta be a lawyer."

   He graduated from Shaker Heights High School in 1969, starring there as a cross-country runner, elected council member, and sports editor of the school newspaper, before heading to Harvard College and Law School. At age 66, he still runs often and is known to bicycle long distances throughout the east side of Cleveland. He's also been a volunteer reading instructor for the Cleveland Municipal School District and the Jewish Community Federation, and is known to keep a schedule packed from morning to night.

   He was appointed as federal judge by former President Bill Clinton in 1998, but his first legal experience was not so liberal: One of his early jobs after law school was with the U.S. Department of Justice, a post he secured after he impressed his interviewer, future Supreme Court justice and conservative legal giant Antonin Scalia.

   He has been married for more than 40 years to fellow Cleveland lawyer Deborah Coleman (she being an expert in antitrust, intellectual property and technology) and they have three adult kids. Those who know him say he is seen quite often at Browns, Cavs and Indians games.

   He is known for two completely different news items in recent years. The first was his handling of the breakaway Amish sect case where the charges of shaving men's beards against their will was filed under the new hate crimes law. Polster sentenced the bishop of that sect, Samuel Mullet, to 15 years in jail (since reduced to 10 years).

   Polster said his challenge was not allowing the oddness of an Amish hate crime case — along with the accused being a beard-cutter ironically named "Mullet" — to become a media spectacle. "I am very glad I had that case in my 15th year as a judge," he told The Federalist Lawyer. "I couldn't have handled it very well as a rookie judge."

   His other recent appearance in the headlines came about a year ago. Polster spoke out against President Donald Trump after the president derided a judge who ruled Trump's Muslim travel ban unconstitutional. Trump called that judge a "so-called judge."

   "This is serious business, because you start calling into question the legitimacy of someone, that undermines the whole system, all right?" Polster said at a private meeting in Bratenahl last February to a small group that included suburban mayors, attorneys and city officials.

   "I think to say it publicly, that's his right. But it calls into question, and some might even say forfeits, his or her own legitimacy. So I'll leave it at that. It's an important question, but that's how I feel ... I don't believe there's a single federal judge who would be intimidated by anybody. We took an oath to support and defend the Constitution and it means a lot. And I think that oath means even more today."

   The power Polster has in this big case is not lost on the Cleveland legal community. There are already more than 200 lawyers listed in the filings, and the big companies are loading up on local Cleveland legal talent to help skew any possible settlement decision their way. "What can happen in [this case] is likely going to result in public policy changes on the federal and state levels," said Lee Fisher, dean and professor of law at Cleveland-Marshall College of Law.

   And one lawyer said doing what Polster has taken on — trying to balance settlement money with public policy changes — will be very difficult to accomplish. But he says Polster might be capable of doing it better than most, in that he knows how to keep all sides in line.

   "A lot of the plaintiffs in these cases — the local and state government agencies — will try to turn this into a punitive damages case to get their public government agencies some money to pay off their expenses from all these overdoses," said one Cleveland lawyer who has tried cases before Polster, but who didn't want his name used. "Think of it this way: How much does it take to punish a big pharmaceutical company that builds these costs into their business plan to survive the long haul? But how will the evidence work that the medical and pharmaceutical profession likely created a culture of pain pills that are addictive and don't do much for pain anyway.

   "The defense might be that the maker of OxyContin gave America what it wanted, and the FDA and the doctors and the many researchers signed off on this," he said. "We are now a pill society. People are in pain. They get pills prescribed for their pain because they really want those pills. How do you blame the pill makers alone for all this? That's what Judge Polster has to deal with."

   And that raises all sorts of legal questions. Some are comparing the Cleveland MDL opioid litigation to the Big Tobacco settlement of 1998. The cigarette companies agreed to pay about $206 billion to the states over the first 25 years. As Mississippi attorney general Mike Moore said back then, "[The] lawsuit is premised on a simple notion: You caused the health crisis; you pay for it."

   Are there legal similarities between cigarette sales in a convenience store and an opioid prescription from a doctor?

   "The public went against the cigarette companies back in the '90s because they were seen as the villains in all this, and that's probably why the settlement amount got so high," said Browne C. Lewis, director of the Center for Health Law and Policy at the CSU law school. "But I'm not sure the public will want to make the medical community villains in all this like they did tobacco. It's a very slippery slope. The pain component of this will be difficult to figure out. They will say their intentions were good in some respects, and they wanted to alleviate pain. And they will have all sorts of examples of people where they did alleviate the pain.

   "So it might come down to the settlement being a change in public health care policy," Lewis said. "Like how we approve pharmaceutical medications and how we oversee prescriptions. How the money fits in will be the hard part to figure out."

   ***

   A few years ago, I interviewed a retired surgeon, now in charge of a residency program at a large medical school, who goes by "Skeptical Scalpel" in his blog. "People are more acclimated to getting medication for anything now, and they expect it," Scalpel said. "Millennials have been overmedicated since they were born. They say they are depressed, and instead of figuring out why, we give them a prescription for Zoloft. ... It's all part of the pill medicalization of the entire country."

   Over the years, demands on doctors have grown. They were now seeing three patients an hour and often had no time to figure out who needs what pain meds and for how many days or months. "What has happened is that we have created a culture where the pain medication is not only expected, it is demanded by the patients."

   Parma mayor Tim DeGeeter sees things a little differently. In 2012, his Cleveland suburb, which is also the seventh largest city in Ohio, had no drug overdose deaths. By 2016, it had 20. And those are just the deaths, not the countless victims who overdosed and survived.

   "The cities are at ground zero in dealing with this, " DeGeeter said. "In 2017, we had to provide overdose help to 136 males, and 64 females in Parma. The youngest was 19, the oldest was 63. These were people who were employed, unemployed, with college degrees, high school grads, it knows no boundaries or group that it settles in. And nothing is getting done in Washington on this.

   "For me as mayor of a city suffering from this, I would be remiss if we did not file a lawsuit on this situation on behalf of our citizens who are paying for this in so many ways," he continued. "We aren't expecting a great windfall, but we are expecting a knock on our door with someone there to say we have settled this and we're here to help and we'll have less people dying in your city."

   Who's knocking though, and who's cutting the check? That's another complicated question in an already complicated situation. Say someone was prescribed OxyContin and, over time, became addicted and overdoses. Who gets the blame?

   Purdue Pharma, which makes OxyContin, is being sued for possibly lying to doctors about the addictive nature of the medicine. (In what many in the legal community say is an acquiescence to Polster, a gesture of sorts, Purdue last month announced it would cease marketing OxyContin to doctors.) Cardinal Health, a prescription distributor based in Dublin, Ohio, is said to be at fault as well, for dumping alarming amounts of painkillers around the country. And then there's CVS and Walgreens and all the other pharmacies that are alleged to have ignored red flags as they bottled billions of dollars of the medications.

   The lawsuits argue that anyone who touched that pill before you ingested it, ground it up and shot it into your arm or snorted it could be said to be liable. The defendants, however, claim they were providing a legal, federally approved prescription. Whatever the individuals did, they did themselves.

   The U.S. Drug Enforcement Agency keeps data on all prescriptions, who dispenses the meds to whom, what was dispensed and how much. The plaintiffs wanted about 10 years' worth of that data; the DEA said that would be a problem. The agency argued it would be "law enforcement sensitive," meaning the Feds feared illegal drug dealers could use the records to target users; but Polster ruled the DEA must turn it over, though the info won't be shared with the public.

   If what we already know about the massive, mindboggling quantities of painkillers shipped to West Virginia is any indication, the numbers Polster looks at for the rest of the country are likely to poke holes in the defendants' case. A Pulitzer Prize-winning investigation from the West Virginia Gazette revealed wholesale pharmaceutical companies flooded Kermit, an old coal-mining town on the Tug River with a population of 400, with 12 million opioid pills between 2007 and 2012, or about 30,000 pills for every resident.

   In total, 780 million opioid pills were shipped to the state over that span, or 433 for every West Virginian.

   Hard data is good, but it opens more questions. Not of who's to blame — it's clear by now the answer to that is everyone involved — but to what degree. How much of this was America's thirst for pharmaceuticals? How much was deceit on the part of Big Pharma? How much do we blame the medical community? How much was it a failure of those charged with overseeing public health?

   ***

   Say Polster gets the sides to agree to a settlement. The first question, of course, is how much money will go to the plaintiffs. The second question is how they would be able to use it.

   The major criticism of the 1998 $250 billion Big Tobacco settlement between the cigarette makers and 45 states was the fact that the settlement — payable over 25 years — gave no stipulations on how the states might spend that money. Many used a small portion of the funds for tobacco control and cessation programs, but most of the dough was typically used for other purposes, such as security for loans or simply for a state's general fund. 

   Ohio sold its future collections from the settlement for $5 billion in a bond sale (estimates say it could have collected more than three times that amount if it hadn't) and used the cash for a variety of things, including paying down debt, giving real estate tax breaks to seniors, funding construction of schools, and spending $20 million to make E-Checks free for all residents.

   No states provided for direct payments from the settlement to individuals, to pay for medical costs resulting from tobacco use.

   The national smoking rate has fallen to historic lows since that settlement, with just 15 percent of adults still smoking. But the gap between the number of less-educated rural smokers and the more-educated urban smokers is higher than ever: Researchers have found that America's lower class now smokes more and dies more from cigarettes than other Americans.

   And again, that underscores the problems with these MDL opioid cases. Is a judge in Cleveland going to be able to rein in opioid addictions nationally, including in small towns in West Virginia? And if the opioid makers and distributors figure that a big multi-billion dollar settlement is just the cost of doing business, will the cities and counties that get big money use it to reduce addiction in the communities or to repair sidewalks and pave streets?

   Oh, and the feds might want in on this as well. In November, Pres. Trump's Council of Economic Advisers estimated that the opioid drug epidemic cost the country $504 billion in 2015, in terms of lost lives, lost productivity, health care, treatment, criminal justice and other costs. If the cities, counties and states are getting theirs, one expert told me, the feds will want to drink from that trough too.

   ***

   Purdue's announcement that it would end OxyContin marketing was a small but tangible sign things are heading in a productive direction. And lawyers remarked to various media following the first settlement conference in January that they were cautiously optimistic after their initial reticence in the face of Polster's bold direction.

   "The parties reported important and substantial progress on several fronts, but also identified various barriers to a global resolution," the judge wrote in a filing after a March 6 meeting. To address some of those barriers, Polster said they agreed to use a "limited litigation track," which basically means a few of the lawsuits may go forward with discovery, motions and trials in what amounts to test balloons so each side can get a feel for how a judge and jury view their cases. He's asked for a plan to be submitted by March 16.

   The next settlement conference is scheduled for May 10.

   Hundreds more will die between then and now, and hundreds if not thousands more will die between May 10 and whenever a settlement might be reached. Maybe Polster really is overly ambitious in thinking he can wrangle a solution that will shrink those numbers one day, but it certainly won't hurt to try.

   "The judicial branch typically doesn't fix social problems, which is why I'm somewhat uncomfortable doing this," he told the Times. "But it seems the most human thing to do."

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9. As Opioid Liability Claims Expand Across the Industry, Consider Your Insurance Coverage

   Mar 14, 2018 | Lexology

   By Tamara D. Bruno

   Regular readers of the Policyholder Pulse know that we often frame coverage issues with a lighthearted or (hopefully) humorous theme, but there’s nothing funny about the opioid crisis that continues to devastate lives and communities across the United States. The extent and impact of opioid addiction are being examined and explained by experts in the field, and we aren’t trying to tackle that subject on an insurance blog. Instead, this post outlines the expanding breadth of opioid liability claims at every level of the industry, and insurance coverage considerations raised by these claims.

   The Expanding Reach of Opioid Liability Claims

   Lawsuits have been filed nationwide by states, counties and cities against the largest manufacturers and distributors of opioids. Many of these have been consolidated in a multi-district federal litigation styled In re: National Prescription Opiate Litigation pending in the Northern District of Ohio. Suits also continue to be filed in state courts or consolidated in this federal action.

   The parties identified as defendants in these lawsuits continue to expand, and often include smaller distributors, clinics or other medical facilities, third-party payors and even individual physicians and pharmacists. The plaintiffs’ side is also diversifying, as lawsuits are now also being filed by non-governmental plaintiffs, including individuals bringing wrongful death or putative class action claims.

   Key Coverage Considerations for Opioid Liability Claims

   Lawsuits alleging liability in connection with the opioid industry are varied and complex, in terms of both the claims alleged and the parties involved. As a result, they raise many complex insurance issues. This post outlines a few of the most common ones:

   Potentially Applicable Policies

   Opioid-related lawsuits can trigger various insurance coverages, depending on the claims alleged. Commercial general liability insurance may respond to some of the claims commonly made in opioid litigation, including public nuisance, failure to report, negligence and negligent misrepresentation.

   CGL policies frequently include exclusions for professional services, however, which could apply to allegations against clinics, doctors or pharmacists relating to prescribing or dispensing opiates. CGL policies also often have exclusions relating to insureds’ products that could apply to some claims. Specialty coverages should be considered for products liability or claims relating to insureds’ performance of professional services.

   Directors and officers of companies involved in the opioid industry might be sued individually, and there could be claims by shareholders relating to the impact on company securities. D&O liability policies may respond to these kinds of claims.

   Keep in mind that many opioid-related lawsuits allege conduct or damages occurring over many years, which could trigger occurrence-based (typically CGL) policies in effect during each of those years. Be careful not to limit claims under one policy type or year if others may apply.

   The Impact of Intent

   Some liability policies are triggered by alleged damages caused by an “accident” and most include some form of exclusion for intentional injury or willful violation of law.

   Opioid-related lawsuits may include claims of fraud, conspiracy, and violations of statutes such as RICO, the Controlled Substances Act and consumer protection laws. Coverage may be denied based on intent provisions for these types of claims or others based on the same allegations. If, however, the lawsuit also alleges claims based on negligent conduct, or, in many jurisdictions, if the prospect of negligent conduct liability exists as a “lesser included” claim within the allegations of the complaint, then those claims are more likely to be covered.

   Note that state law differs about whether defense costs can be allocated between covered and un-covered claims, or whether insurers can seek reimbursement of defense costs if an insured ultimately is found liable on a claim that is not covered. Policy wording and applicable law can make significant differences as to available coverage.

   Coverage for Alleged Damages

   Certain coverages, such as CGL and some professional liability policies, cover damages for or because of “bodily injury.” Governmental units bringing opioid-related lawsuits typically allege damages such as increased costs of care and law enforcement. Courts have issued mixed decisions on whether these lawsuits allege “bodily injury” damages. Wording that could make a difference is whether the policy covers damages “for” or “because of” bodily injury, with the latter term being interpreted more broadly and potentially including government response costs. CGL policies may also state that bodily injury damages include damages for care or loss of services resulting from bodily injury, which arguably applies to damages like those alleged by governmental plaintiffs.

   Insurers may raise other damages-related exclusions such as for fines or penalties, or for profits to which the insured was not legally entitled. Application of such exclusions depends largely on what damages are sought by the plaintiffs.

   ***

   If you or your organization is involved in any way in the manufacture, distribution, prescription of or payment for opioids, you should have your insurance program evaluated for coverage of opioid-related lawsuits. If you have already received claims for alleged liability relating to opioids, make sure you’ve checked for all potentially applicable policies and understand how your coverage should apply.

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Commentary and FYIs

10. Opioid Overprescribing Is Not a Myth (Opinion)

    Mar 13, 2018 | Politico Magazine

    By Jane Ballantyne, Gary Franklin And Andrew Kolodny

    From the beginning of the opioid crisis in the 1990s, when reports of addiction and overdoses involving OxyContin first surfaced from Appalachia and New England, spokespersons for the drug’s manufacturer, Purdue Pharma, insisted that problems were limited to drug abusers, not average patients. Prescribers and policymakers were told, misleadingly, that the development of addiction, even with long-term daily use, occurred in less than 1 percent of patients. By the early 2000s, when it became clear that opioid prescribing was soaring far beyond levels that could be clinically needed, and that rates of addiction and overdose death were rising in parallel, industry-funded opioid advocates continued to argue that addiction in patients was rare and that diversion from legitimate medical channels was the root of the problem. Policymakers were cautioned that efforts to reduce prescribing would unfairly penalize pain patients for the bad behavior of drug abusers.

    These familiar arguments are repeated in a recent article in Politico Magazine by Dr. Sally Satel, a resident scholar at the American Enterprise Institute. Satel writes that “we must be realistic about who is getting in trouble with opioid pain medications. Contrary to popular belief, it is rarely the people for whom they are prescribed.” Yes, it oversimplifies matters to suggest that every opioid-addicted American developed the condition from legitimate medical use. But let us be clear: Opioid use disorder is common in chronic pain patients treated with long-term opioids, and our nation’s opioid addiction epidemic stems largely from the overprescribing of opioids for the treatment of pain. Satel suggests that efforts to promote more cautious prescribing are harming patients with chronic pain. We suggest the opposite: that a lack of understanding of chronic pain, and an overreliance on opioids to treat it, is compounding both the opioid crisis and the problem of inadequately treated chronic pain.

     There are some forms of chronic pain that can be helped by intermittent use of low-dose opioids. However, the most common forms of such pain are not diseases, but symptoms of underlying conditions, such as arthritis or diabetes, which we believe are best managed without resort to opioids. In fact, for many common pains, opioids are ineffective or can worsen both the pain and the long-term outcome. Sometimes, through their sedating effects, opioids can also reduce the motivation to utilize safer approaches such as stretching and exercise.

     Satel’s assertion that addiction rarely develops in patients taking long-term opioids for pain is dangerously misleading. The two systematic reviews she cites, to support a claim that the risk of addiction in chronic pain patients could be less than 1 percent, combine data from clinical trials that are several years old and are largely industry-funded. Clinical trials that limit the type of patient, the doses and the duration of treatment are not reflective of real life. Studies that have attempted to assess real-life rates of addiction in populations of patients receiving opioids for chronic pain have calculated much higher rates: up to 25 percent using strict addiction criteria and even higher—around 50 percent—for problematic use more broadly. Even this ignores that there is no consensus on what constitutes addiction when it arises in patients who are treated continuously and legitimately with opioids and who may not even reveal addictive behaviors until they are denied opioids.

     It is true that our record high levels of opioid overdose deaths have not been produced entirely by opioid-addicted pain patients overdosing on their medication. Many individuals become addicted to prescription opioids through medical or non-medical use, and then switch to heroin after becoming addicted. Over the past few years, overdoses deaths have risen rapidly among these black-market opioid users because illicitly synthesized fentanyl is increasingly mixed with heroin or sold as heroin.

     But to deny that the sharp increase in prescribing of opioids, caused by a multi-faceted marketing campaign, contributed significantly to today’s epidemic, is to deny the obvious. Millions of legitimate pain patients that continue to take opioids exactly as prescribed are struggling with poor pain control and lives ruined by opioid dependence. Even if only a small percentage of people briefly exposed to opioids after minor injury or surgery become addicted, that is too many; if non-opioid medications were used, those people might otherwise never have been exposed or become addicted.

     We agree with Satel that the answer is not to force millions of chronic pain patients to rapidly taper off medications they are now dependent on. But then neither is the answer to absolve overprescribing for pain.

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11. Opioid Maker Funds Efforts To Fight Addiction: Is It ‘Blood Money’ Or Charity?

    Mar 14, 2018 | Kaiser Health News

    By Jenny Gold

    A program to give naloxone overdose-antidote kits and training to front-line officers. Funding for pill disposal boxes in pharmacies, clinics and police stations across North Carolina. A radio campaign in Connecticut warning of the dangers of opioid abuse. A new medicine to treat opioid-induced constipation.

    The money behind these efforts to combat the opioid epidemic and its side effects comes from a perhaps unlikely sponsor: Purdue Pharma, the company that makes the top-selling opioid, OxyContin.

    After years of aggressively promoting OxyContin as a safe and effective way to combat pain, the company is — equally aggressively — recasting itself as a fundamental player in the response to a crisis that many experts say it helped to create. Such efforts come amid hundreds of lawsuits claiming that Purdue fueled the opioid epidemic by deceptively marketing OxyContin, as well as new government efforts to regulate opioids.

    In February, Purdue announced that it would stop promoting its opioid drugs to physicians. At the same time, Purdue is looking to partner with other companies and expand its portfolio into areas such as oncology and sleep medicine. OxyContin accounted for more than 94 percent of Purdue’s sales in 2012 and was still over 82 percent as of last year, according to Symphony Health.

    While patient groups and communities have been quick to accept money for programs they could otherwise not afford, families who have lost loved ones to opioids are not easily placated.

    When Sue Kruczek heard the Purdue-sponsored radio ad on her local station, warning of the dangers of opioid addiction, she was so appalled that she said she “almost had to pull over.”

    “It’s sickening. It makes me feel sick. I hold Purdue personally responsible for this epidemic,” said Kruczek, who lost her son Nick to an opioid overdose in 2013, just a week shy of his 21st birthday. “It’s blood money at this point.”

    Kruczek said she was also unimpressed by the full-page ads Purdue placed in major newspapers in December, touting its “abuse-deterrent” OxyContin formulation and support for the Centers for Disease Control and Prevention guidelines for safe prescribing.

    Greg Williams, executive vice president of Facing Addiction, a nonprofit group that advocates for people struggling with addiction, noted that the ads were published just months after a coalition of 41 states’ attorneys general subpoenaed records from major opioid manufacturers, including Purdue. “The timing of this recent blitz is not an accident — they were quiet for a long time,” he said of the ads and donations, calling them a tactic to avoid paying more later. “They’re spending millions of dollars to do this when they owe billions,” he said.

    Purdue said it is wrong to blame the company for the opioid crisis, which resulted in 42,000 overdose deaths in 2016. The Council of Economic Advisers estimated that the crisis cost $504 billion in 2015, or 2.8 percent of GDP.

    “Pointing fingers isn’t a way to get the resolution we need,” Robert Josephson, a spokesman for Purdue, said in an interview. “Pointing to one company and one product that never constituted more than 3.6 percent of total prescriptions really misses the mark.” The advertisements all end with the phrase: “We want everyone engaged to know you have a partner in Purdue Pharma. This is our fight, too.”

    Some programs that have benefited from Purdue’s donations say they were unaware that the drugmaker had provided the funding — though in the midst of a crisis they were nonetheless grateful.

    As part of Purdue’s partnership with the National Sheriffs’ Association, the sheriff’s department in rural Wood County, Ohio, received about 60 doses of naloxone for officers to carry. So far, the department has used about seven doses to revive people experiencing an overdose.

    Sheriff Mark Wasylyshyn said that when he received the kits he was not aware that Purdue had provided the funds. But, he said, it would not have affected his decision to accept them. “I think whoever wants to do it, it’s wonderful,” he said. “If they wouldn’t have done it, I wouldn’t have had it to save those seven lives.”

    Fred Wells Brason II, president and CEO of Project Lazarus in North Carolina, which partnered with Purdue to install pill disposal boxes across the state, said the organization had received little pushback for accepting the donation. The drug companies “are not going to go away. We need them, and patients need them. We just want to make sure prescribing is safe and responsible,” he said.

    OxyContin sales have been dropping in recent years, from $2.8 billion in 2012 to $1.7 billion in 2017, in part because of competition from generics. Unlike other opioid manufacturers such as Johnson & Johnson, which makes hundreds of products, Purdue is known almost exclusively for its opioid drugs.

    That is partly why it is soliciting business partnerships to diversity its portfolio. But one of the first of the new products feels to some like an affront: Acquired through a partnership with Japanese company Shionogi Inc. and approved last year, Symproic is a pill to treat opioid-induced constipation — a common malady of people taking the pain meds. It costs about $350 per month.

    Purdue’s recent promise to cut half of its sales staff and stop marketing OxyContin to physicians altogether is unlikely to have much of an impact, especially since there are already generic versions of the drug, said Andrew Kolodny, co-director of opioid policy research at the Heller School for Social Policy and Management at Brandeis University.

    “Once drug companies have generic competition, they often stop promoting anyway,” he said, adding that OxyContin is still being marketed aggressively in other countries through Purdue’s international arm, called Mundipharma. Although OxyContin is still protected by a Purdue patent, it is available in multiple generic equivalent forms, sold by generic drug companies with Purdue’s permission.

    The company’s approach is nothing new, said Mike Moore, a former attorney general of Mississippi who is currently consulting on several major cases against Purdue. “They have had a history of tiny half-steps every time someone begins looking at them,” said Moore. In 2002 for example, Moore recalled, Purdue gave Florida $2 million for education and prevention programs to combat opioid abuse. “That’s like pennies in a coffee can. It doesn’t do anything,” said Moore.

    Any global settlement with Purdue and other opioid manufacturers would need to be at least $100 billion to seriously address the opioid crisis, Moore said.

    Even as Purdue has cut back its sales force and has been spending on harm reduction, it continues to promote prescribing of opioids.

    From 2012 to 2017, for example, Purdue gave $4.15 million in funding to patient advocacy organizations and professional societies such as the Academy of Integrative Pain Management and the American Academy of Pain Medicine, a recent U.S. Senate investigation found. Many of the groups, in turn, issued statements and guidelines that minimized the risk of long-term use of opioids to treat chronic pain, according to the Senate’s report.

    In 2007, Purdue pleaded guilty in federal court to misleading doctors and patients about OxyContin’s risk of addiction and potential for abuse, and agreed to pay $600 million in fines. The period under investigation, however, ended in mid-2001. Since then, Josephson said, Purdue has learned from its past mistakes and has an excellent track record. “We as a company have been addressing prescription drug abuse for 15 years,” said Josephson.

    Thus far, critics note, Purdue’s efforts have not included methods that would significantly reduce or limit sales of OxyContin, the company’s blockbuster high-dose opioid drug. In statements about opioid misuse, for example, Purdue avoids the use of the term “addiction” and instead focuses on “abuse” of drugs.

    “There’s a real sense that they’re saying, ‘We’re not the drivers of the problem, the addicts are the drivers of the problem. We’re going to try to help, but really it’s the addicts and the people trafficking in this illegally that are the problem,’” said W. Timothy Coombs, a professor of crisis communications at Texas A&M University.

    Said Adriane Fugh-Berman, who studies pharmaceutical marketing practices at the Georgetown University Medical Center: “If they were really sincere, they would be looking for ways to sell fewer opioids. We’re not seeing that.”

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12. Justice or Profit?: Lawyers scour Texas for opioid lawsuit clients (Opinion)

    Mar 14, 2018 | Texarkana Gazette (AR)

    By Staff

    Both Miller County, Ark., and Bowie County, Texas, are among the more than 100 states, counties and cities currently suing opioid manufacturers in federal court.

    The allegation is that large pharmaceutical
    companies minimized or even misled the public about the dangers posed by prescription drugs such as oxycodone and hydrocodone. In their quest to maximize profits, the suits charge Big Pharma disregarded the health and well being
    of patients.

    The opioid crisis has been in the news a lot. Prescription drug abuse has taken the spotlight once focused on heroin and other illegal drugs.

    With good reason, since ready availability means addiction, overdoses and deaths from such drugs have skyrocketed over the past two decades. That means government agencies have to spend more and more to fight the plague and treat its victims. And they want that money back.

    Sound familiar? It should. It was the same rationale used in the big tobacco lawsuit back in the late 1990s. Since much of it was litigated here, many residents are no doubt familiar with the case. Tobacco companies ended up agreeing to pay a minimum of $206 billion over 25 years.

    The lawyers in the case got a hefty chunk of that money. The states got a lot more, much of which was never used for anything related to reducing tobacco use or caring for those impacted by smoking, according to data compiled by the American Lung Association. And it looks like they all hope to do the same this time around.

    According to a report Tuesday in the Texas Tribune, law firms are combing the Lone Star State making presentations to city and county officials, hoping to sign them up for a free ticket in what could be the opioid lottery jackpot.

    Yes, if all goes as planned then governments and lawyers should reap a big payday here. And Big Pharma will likely have to modify their marketing somewhat and take out their checkbooks, but that's just the cost of doing very big business.

    Are these folks looking for justice or simply filing for dollars? Will any of this help reduce the pain and suffering opioid addiction has caused, or just fill some government coffers and boost some law firm profits?

    That's the big question.

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13. Overdose antidote availability doesn't always mean fewer deaths, study says

    Mar 14, 2018 | CNN

    By Susan Scutti

    Naloxone, a drug that rapidly reverses opioid overdose, has become more widely available as the United States struggles with an epidemic of drug abuse.But state laws that provide wider access to naloxone, sold under brand names including Narcan, may unintentionally increase opioid abuse, according to a new study published in SSRN, a collaborative research network.

    As access to a lifesaving drug reduces the risk of overdose death, more dangerous drug use -- including higher doses -- becomes more appealing, the researchers speculated. Such increased abuse may even lead to higher death rates.

    "While naloxone can be a good harm-reduction strategy, it's clear that naloxone access alone is not a solution to the opioid epidemic," said Jennifer Doleac, one of the study's authors and an assistant professor of public policy and economics at the University of Virginia. "As currently implemented, these policies may be making things worse.

    "Responding to an epidemicOriginally used only by doctors and first responders, naloxone can quickly restore normal respiration to a person whose breathing has slowed or stopped due to an overdose of heroin or prescription painkillers, according to the National Institute on Drug Abuse.

    In recent years, some states have expanded naloxone access -- by permitting purchase without a prescription, for example -- as a response to the epidemic of opioid abuse.

    For the new study, Doleac and her co-author, Anita Mukherjee, an assistant professor at the Wisconsin School of Business at the University of Wisconsin-Madison, examined the effects of broadened access to the lifesaving drug across the United States." 'Moral hazard' is an economic term meaning that people will do more of something when it becomes less risky," Doleac said.

    She gave the classic example of automobile seat belts, which may encourage more reckless driving, according to some studies.

    "We were interested in to what extent making opioid abuse less risky leads to more opioid abuse," Doleac said. She and Mukherjee estimated the effects of naloxone access laws across the 50 states and made comparisons across regions.

    "The main takeaway is that broadening access to naloxone leads to an increase in opioid abuse," she said.

    'Treatment availability'

    "Even though the risk of death per opioid use has fallen, the number of uses increases enough that the same number of people are dying," Doleac said. Overall, broader access to the drug also has no net effect on mortality rates, she noted, though in some regions, increased deaths occurred.

    In Midwestern states, wider access to naloxone correlated to a 14% increase in opioid-related deaths, plus an 84% increase in fentanyl-related deaths. Greater access also swelled the number of opioid deaths in the South, the study claimed.

    However, the West and Northeast experienced the opposite effect, in which increased access was followed by decreased opioid deaths.

    The impact of access appears to be related to treatment availability, Doleac said. "In the best-case scenario, saving someone's life with naloxone gives them a chance to get treatment," she said. "But that will only happen if there's treatment available."

    Doleac and Mukherjee also estimated the average effects of naloxone access laws in urban areas across the country.

    After the passage of laws that expanded access to naloxone, "arrests for possession and sales of opioids increased by 17% and 27%, respectively, opioid-related visits to the emergency room increased by 15%, and opioid-related theft increased by 30%," Doleac and Mukherjee noted in their study.

    Drilling down on ER visits and deaths, the researchers compared two urban groups: the top 25 largest cities (based on population) versus small to large cities. In small to large cities, naloxone access laws were followed by a 23% increase in the number of opioid-related ER visits and a 42% increase in fentanyl-related deaths. However, the same effects were not seen in the largest cities.

    Doleac said she feels confident in the findings, as the "analysis has been put through the wringer over the past year."

    'Causation' versus 'correlation'

    But Mary Hawk and James Egan, both assistant professors, and Chris Keane, an independent researcher, all of the University of Pittsburgh Graduate School of Public Health, had some cautions about the new study. They were not involved in the research, though they published a separate recent study of naloxone.

    "First, we need to be careful about assuming causation from correlation when thinking about the impact naloxone laws might have on crime, opioid use, and other factors," Hawk, Egan and Keane wrote in an email.

    "We are particularly concerned about the authors' suggestion that increased access to Naloxone may result in increased crime or theft," they said. Just because both expanded during the same time period does not mean that one caused the other. And even if cause and effect were proved, they would not propose removing access to a life-aving drug simply to reduce crime, they said.

    "Is naloxone in itself the answer to opioid epidemic our country is experiencing? Certainly not, but it is part of the continuum of care that we are working to develop," they said. "Our own recently-published study suggests that distributing naloxone in community settings where those who use opioids are likely to visit may result in a drop of approximately 65% of deaths" compared with beforehand.

    Hawk, Egan and Keane say they understand concerns about opioid users who are saved from overdosing numerous times without appearing to change, since their repeat behavior could cause compassion fatigue among first responders.

    "Addiction is often described as a chronic condition of which relapse is fairly common," Hawk, Egan and Keane said. "At a very basic level -- the longer we are able to keep individuals alive, the more chance they have at being successful in recovery." To withhold access to a lifesaving intervention is not only counterintuitive with regard to addiction treatment, it is unethical, they said.

    Philip J. Cook, a professor of economics and sociology at Duke University, said he finds the results of the new study "to be entirely credible."

    Cook, who was not involved in this research, said the results suggest "that some drug abusers are making choices based on their perception of the risks that they will die."

    "One implication is that opiate drug abuse has a voluntary element," Cook said. "It is to some extent a 'choice,' not just a compulsion, influenced by the perception of immediate consequences."

    Doleac said one thing is clear: "We need to keep working to find ways to reduce rates of addiction and mortality."
    

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Southeast (GA, AL, NC, FL, WV)

14. Madison Co. to join suit against pharmaceuticals, distributors

    Mar 14, 2018 | Madison Journal Today (GA)

    By Staff

    Madison County is joining with other north Georgia counties to fight against opioid pharmaceuticals and distributors.

    County commissioners agreed March 5 to take part in a class-action suit against major players in the opioid business in an effort to recoup some of the costs the opioid crisis has imposed on governments for law enforcement, court, medical and other expenses. 

    
    Daniel Haygood, county attorney for Oconee County, spoke to commissioners on behalf of the Athens law firm Blasingame, Burch, Garrard & Ashley, P.C., which is handling the suit. He said Oconee County and Clarke County are already on board with the suit, with a number of other counties considering participation. 
    Haygood noted that opioids are a $378 billion industry in the U.S. and the manufacturers and distributors are now facing a wave of suits for their role in the wrecked lives and massive societal costs for widespread drug manufacture and distribution of something similar to heroin. 

    
    “I don’t think there’s anybody sitting in this room who hasn’t had some contact with the cost of this,” said Haygood to the Madison County BOC. “When I look at all of this, the opioids out there are basically one molecule removed from heroin. And we all know how addictive heroin is. And what the drug companies said was, this stuff isn’t addictive. And when people were having addiction issues, they came back and said that’s pseudo addiction and you just need to prescribe more…For every 100 Americans, there are 83 opioid prescriptions written each year.”

    
    Madison County commission chairman John Scarborough said that in 2012 there were 123 opioid prescriptions for every 100 Madison County residents.

    
    “Stop and do that math,” he said. “It’s kind of upside down.”

    
    Haygood listed about 10 opioid manufacturers and distributors and said they are being sued for an array of bad acts, including negligence, false advertising, nuisance, unfair competition, consumer fraud, false claims, fraud, unjust enrichment, gross negligence, civil conspiracy, unfair and deceptive practices and insurance fraud.

    
    The lawsuit will be filed in federal court in Athens and then transferred to a judge in Ohio who is handling opioid cases.

    
    “He (the judge) has given word that this should be settled, in talking with the pharmaceutical companies and the distributors and key opinion leaders,” said Haygood. “That’s his way of saying he thinks they’re liable and that they should probably come to some arrangement on this. Who knows if that will happen. My opinion is it will happen fairly quickly or these lawsuits will be sent back to the district courts.”

    
    Haygood said counties won’t bear any cost for the lawsuit. The law firm will get 30 percent of whatever damages are awarded against the drug companies to the counties. 

    
    “If there’s no recovery, there’s no fee and there will be no public funds expended in doing this,” he said. “There’s enough here that as good stewards of county resources, we ought to be involved in it. We ought to take advantage of the fact that there might be some money there that we could use for the things that it (opioids) has cost.”

    
    Commissioners said it’s shocking how bad the opioid crisis has become. They unanimously approved a resolution for a legal agreement with Blasingame, Burch, Garrard & Ashley, P.C.
    

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15. Decatur Co. votes to join opioid lawsuit

    Mar 13, 2018 | The Post Searchlight (GA)

    By Powell Cobb

    The Decatur County Board of Commissioners unanimously voted for the county to join a wave of lawsuits against opioid manufacturers and distributors.

    The lawsuits claim opioid usage has become an epidemic in Georgia, putting strains on healthcare, draining public resources and increasing costs on law enforcement.

    Decatur County is just one of many other counties, including Athens-Clarke County, Cook County and Crisp County, who have emerged to fight against the growing opioid problem in Georgia.

    The board voted for Athens law firm Blasingame, Burch, Garrard & Ashley, P.C. to represent Decatur County, along with Bruce W. Kirbo, Jr. Attorney at Law, LLC.

    Counties have piled on to join the lawsuit in the past month

    “It is a real problem for the system, between law enforcement, healthcare and all of these other issues,” said Alan Thomas, Decatur County Administrator. “That’s why we’re getting onto it, just like everyone else. Something needs to be done to counteract the problems it has created.”

    The Bainbridge City Council discussed joining the lawsuit at its meeting on Feb. 20. Now that Decatur County has joined the mix, the city and the Hospital Authority will likely seriously consider joining the lawsuit as well.

    Opioids include painkillers like OxyContin, Vicodin, Percoset, morphine, heroine, Fentanyl and Carfentanil.

    These drugs release dopamine, which causes pleasure, relieves pain and slows down breathing. Unfortunately, 91 people die from an opioid overdose every day. Deaths from prescription opioids have more than quadrupled since 1999 and providers in the highest prescribing counties provided six times more opioids than those in the lowest prescribing counties.

    Hall County, Cook County, Madison County, Irwin County, Walton County, Athens-Clarke County, Candler County, The Candler County Hospital Authority, Oconee County, Crisp County, Jeff Davis County, Sumter County, and Oglethorpe County have all joined the lawsuit through firm Blasingame, Burch, Garrard & Ashley, P.C., as well as through other lawfirms.

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16. Shelby County files lawsuit against opioid manufacturers

    Mar 14, 2018 | WBRC (AL)

    By Alan Collins

    Shelby County is taking steps to combat opioid abuse.

    The Shelby County Commission approved hiring two law firms to file suit against opioid manufacturers Monday night.

    Compact 2020 was created in Shelby County to build partnerships to deal with a growing opioid crisis in the county.   

    "It really got our attention as we continued to see young and younger people die as a result of opioid abuse," Compact 2020 Director Alan Miller said.
    
    The county commission voting to sue drug manufacturers because of the county's growing cost of combating opioid addiction from law enforcement to deaths.

    "The entire effect of it will be heard for generations to come. We in effect losing substantial portions, particular younger people who are addicted," Shelby County Attorney Butch Ellis said.    

    Ellis hopes the lawsuit will lead to a change in how drug companies distribute their products in the county and across the country.  

    "Improper manufacturing and distribution practices and we hope these lawsuits including Shelby County's modify that behavior," Ellis said. 

    Miller, an assistant Shelby County District Attorney says the crisis hit some county families hard. The addiction has a devastating impact on families.

    Families try to handle this on their own and they don't know where to seek help," Miller said.
    
    Jere Beasley’s law firm, Beasley Allen in Montgomery, has also been hired to litigate the case.

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17. County considers suing drug companies

    Mar 14, 2018 | The Mountaineer (NC)

    By Vicki Hyatt

    The Haywood County Commissioners are mulling over the prospect of suing opioid manufacturers and distributors to recover costs related to the opioid epidemic sweeping the county.

    An attorney leading the charge in North Carolina says there are no upfront costs to participating in the legal effort, but cautioned that those who don’t participate won’t be receiving any settlement funds.

    Don Vaughan, a Greensboro attorney who is a former legislator and is a state and local government professor at Wake Forest and Elon law schools, predicts the settlement will be even larger than the 1998 agreement with the four largest tobacco companies in the U.S.

    That agreement guaranteed a minimum payout of $206 billion as compensation to states for smoking-related medical costs incurred the the states.

    County Commission Chairman Kirk Kirkpatrick said he has spoken with attorneys representing cities and counties across the state in the action.

    “It’s not a class action, but is similar,” he explained. “A municipality or county can use law firms in the state that are handling the cases. We’re trying to get a gauge on the issues regarding the suit, particularly the parties they are going after as far as wholesalers.”

    Kirkpatrick, who is an attorney and recently became a part-owner in a pharmacy, said he understands how difficult it is to get approval to distribute opioids, though he admits it might not have been that way early on.

    “It’s not like a pharmacy can order anything they want,” he said. “They are limited by the manufacturers and distributors. We’re dealing with an issue that’s multifaceted.”

    When he looks at a lawsuit, Kirkpatrick said he considers  the probable cause of the damages.

    “Here you have got opioid abuse, but is the cause the distributors and manufacturers or are there other people involved? There’s stealing from other folks; you can’t get an opioid without a prescription; are we second-guessing doctors who aren’t part of the action?” he said.

    As an attorney, Kirkpatrick said he certainly understands “why they are suing who they are suing” as it is the drug manufacturers and distributors that have the money.

    Kirkpatrick said in the case of the tobacco settlement, the money went directly to the state, and said it will be important to learn how the funds will be distributed.

    Nonetheless, if there are funds that could be made available for counties reeling from the opioid epidemic, Kirkpatrick said he certainly wants Haywood to be considered.

    There’s a single point Kirkpatrick believes would provide the biggest advantage in the lawsuits against the drug companies going forward.

    “When the drugs initially came out, the companies said they were not addictive,” he said, “but it has been proved now they are clearly additive, and probably (the companies) had scientific information at the time to show they would be addictive.”

    The lawsuit

    Vaughan is one of the North Carolina lawyers involved with the nation’s largest legal efforts concerning the opioid crisis. So far, 25 counties in North Carolina and a number of cities have signed on to the effort to recover the dollars spent on behalf of their county or municipality related to the opioid crisis.

    “Our targets are the wholesalers and distributors of opioids, not the pharmacies or doctors,” Vaughan said.

    The firms handling the effort represent over 200 counties and cities nationwide, from New Mexico to St. Louis to Cincinnati, he said.

    “Our team includes the nation’s best experts in the opioid crisis,” he said. “If retained, they will look at such expenses as law enforcement, medical and other expenses to determine what has been spent on the crisis over the past years which can be directly attributed to opioid misuse. Our effort will pay all the expenses on behalf of those participating — all legal costs, expert fees, everything.”

    It is already known the case will be heard in Ohio and a federal judge has taken charge of all the multi-district litigation in the U.S., Vaughan explained.  The judge’s latest comment is he would like to have all cases settled in the U.S. by the end of 2018 or begin litigating in early 2019.

    “This is different than a class action law suit because if a county is not litigating, they will be left out of any recovery. It’s expected this litigation will be larger than the tobacco settlement. It may be the nation’s largest litigation ever,” Vaughan said, pointing out the drug manufacturers and distributors made $420 billion last year from the opioid sales that are at the center of the crisis.

    Local discussions

    County Attorney Chip Killian was part of a briefing on the lawsuit several months ago and has briefed the board on what he learned.

    “It’s their decision,” he said. “They are watching to see what goes on elsewhere.”

    He said there could be a downside if those suing got saddled with attorney fees should the case be found to be without merit, but other than that, Killian said he sees no downside.

    Waynesville Mayor Gavin Brown said if the county participates, he isn’t sure it’s necessary for each municipality to participate.

    “This issue goes to the survival of the community as well as the individual victims,” Brown wrote in a text response. “I offered my services to Chip if the county chose to proceed with the suit.”

    Canton Mayor Zeb Smathers said he was asked early on to be part of the litigation as an attorney, but chose not to as he feared it could pose a conflict with his mayoral duties.

    “I see this all the time,” he said, noting he has lost more clients to the opioid epidemic in the last two years as he saw in his first eight years of practice. “I’m passionate about it. This is an epidemic. People are dying, and we have to take the fight to the dog and use every resource possible and every avenue available to combat this epidemic. If the county is on board, I think we would jump on it, but we haven’t been approached as a board or otherwise.”

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18. Palm Beach County picks legal team to pursue opioid litigation

    Mar 13, 2018 | Sun Sentinel (FL)

    By Skyler Swisher

    Palm Beach County has joined a growing legal battle against drug companies to recoup the costs of fighting an opioid epidemic that is killing more than 1,000 people every year in South Florida.

    Commissioners voted 4-2 Tuesday to select a legal team consisting of The Ferraro Law Firm; Napoli Shkolnik PLLC; and Stull, Stull & Brody.

    Lawsuits aimed at the pharmaceutical industry have accused drug companies of misleading patients and doctors about the dangers of prescription medication, producing a public health emergency that is straining government services.

    Attorneys say they expect to recoup damages that could exceed the totals reached in landmark litigation against tobacco companies

    “The only thing these companies truly understand is money,” said Paul Napoli, one of the lawyers who will be representing the county.

    Palm Beach County joins other local governments in seeking relief. More than 300 cities and counties across the country are pursuing litigation, including Broward County, Fort Lauderdale and Delray Beach.

    Nine teams of attorneys submitted proposals to the Palm Beach County.

    Drug makers and drug distributors have denied wrongdoing. In response to a lawsuit filed by Osceola County, Purdue Pharma issued a statement that the company followed all federal guidelines, helped law enforcement gain access to the overdose antidote naloxone and developed three new opioid medications with “abuse-deterrent properties.”

    Before a crackdown seven years ago, Florida was known as the nation’s pill mill capital, where doctors handed out oxycodone and other powerful painkillers like candy at storefront clinics. In 2010, 98 of the top 100 opioid-prescribing physicians were in Florida, according to the Drug Enforcement Agency.

    Now, medical examiners are seeing unprecedented overdose deaths caused by heroin and ultra-potent synthetic versions of the drug.

    As a destination for people seeking recovery, Palm Beach County has been hit hard by the opioid epidemic. The county recorded 606 opioid overdose deaths in 2017, up from 596 in 2016, Palm Beach County Chief Medical Examiner Dr. Michael Bell said.

    Palm Beach County Fire Rescue estimates it costs about $1,500 to respond to an overdose call, and more than 4,000 were recorded in 2016, totaling $6 million in added costs.

    Commissioners Mack Bernard and Dave Kerner cast dissenting votes, citing concerns about a part of the contract that makes the law firms responsible for all possible costs in the case.

    They wanted an opinion from The Florida Bar on whether such a provision was allowable.

    But County Mayor Melissa McKinlay urged the board to act quickly given that people are dying of overdoses every day in the county.

    Last year, the county allocated $3 million in local funding specifically to address the opioid. Funds will be used to open an opioid overdose emergency room where paramedics could take people with addiction and connect them with treatment, expand the number of treatment beds and hire an administrator to coordinate the county’s response.

    The Florida Legislature approved $53 million in funding for treatment and prevention, along with limitations on opioid prescribing and additional training for doctors.

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19. Barbour, Taylor county commissions sue over opioid epidemic

    Mar 13, 2018 | The Exponent Telegram (WV)

    By Matt Harvey

    Two more West Virginia county commissions have sued multiple pharmaceutical companies, drugstores and the West Virginia Board of Pharmacy over West Virginia’s opioid crisis.

    The latest county commissions to sue are Barbour and Taylor. They are represented by attorneys Truman and Letitia Chafin of Williamson; Hunter B. and Catherine A. Mullens of Philippi; Mark Troy of Charleston; Harry Bell Jr. of Charleston; and John Yanchunis, Patrick Barthle and James D. Young of Florida.

    The lawsuits seek temporary and permanent restraining orders to curb practices they contend are fueling the crisis; restitution; and punitive damages for “defendants’ willful, wanton, malicious, oppressive and intentional actions.” An insurance award also is sought from the Board of Pharmacy.

    Among county commissions previously suing were Harrison, Lewis, Brooke, Hancock, Marshall, Ohio, Tyler and Wetzel, against many of the same defendants but using a different set of plaintiff lawyers. That lawsuit is pending in Marshall County Circuit Court.

    In all of the cases, the commissions are seeking compensation for a wide array of expenses and damages the commissioners contend were generated by the opioid crisis — from addiction, overdose and death, to litter, damage to public property and increases in crime and even higher regional jail bills.

    The defendants knew opioids were dangerously addictive, yet flooded the state with the prescription drugs through various unscrupulous practices, the Taylor and Barbour lawsuits assert. That included “encouraging physicians to increase dose amounts and frequencies over time to keep up with patients’ increased tolerance,” the Barbour and Taylor lawsuits assert. “The result: An addicted population with only more profits to be made for Defendants.”

    The lawsuits filed Tuesday also referred to defendants McKesson, AmerisourceBergen and Cardinal as “the Big Three.” They labeled them and others as akin to “sharks circling their prey” and descending “upon Appalachia for the sole purpose of profiting off of the prescription drug-fueled feeding frenzy ....”

    Unless a settlement is reached, the litigation is expected to last years.

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Midwest (IN)

20. West Lafayette files federal lawsuit against opioid makers

    Mar 13, 2018 | Purdue Exponent (IN)

    By Staff

    The city of West Lafayette formally joined a growing list of other Indiana municipalities suing more than a dozen drug companies this week for what it alleges was a calculated push of a class of dangerous drugs.

    The 166-page complaint, filed by Indianapolis law firm Cohen & Malad, includes statistics showing that Indiana and Tippecanoe County have been particularly hard hit by increases in abuse of opioid drugs in the last several years.

    Using news reports and medical studies, the court documents allege a campaign of misinformation and deceit concerning how well opioids such as Oxycontin work and their addictive properties.

    Purdue Pharma, which has no connection to Purdue University, has been especially enriched by its opioid campaign, according to lawsuit.

    "The success of Oxycontin brought a whole new level of wealth to the Stackler family that owns Purdue," the lawsuit alleges in referring to a 2016 investigation by the Los Angeles Times. "Forbes magazine last year estimated the Sacklers' worth at $14 billion,, which put the family ahead of American dynasties such as the Mellons and the Rockefellers."

    The city is seeking compensation for the costs of managing the opioid epidemic, such as increased law enforcement and treating addicted babies, and "an 'abatement fund' for the purposes of abating the opioid nuisance." 

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Southwest (OK)

21. Opioid manufacturers and distributors sued by Ponca Tribe

    Mar 14, 2018 | NewsOK (OK)

    By Randy Ellis

    The Ponca Tribe filed a federal lawsuit against 26 drug manufacturers and distributors Tuesday, accusing them of contributing to the tribe's opioid epidemic by fraudulently misrepresenting the risks and benefits of the addictive painkillers.

    The lawsuit is similar to a number of other lawsuits against opioid manufacturers and distributors that have been sweeping the nation.

    Opioid manufacturers and distributors "flooded the market with false declarations designed to convince doctors, patients and government entities that prescription opioids posed a low risk of addiction," The Ponca Tribe of Indians of Oklahoma alleged in its Oklahoma City federal court lawsuit. "Those claims were false."

    The result has been an opioid epidemic, with 1 in 10 Native Americans over the age of 12 using prescription pain medicine for nonprescriptive purposes, the tribe said, citing 2012 statistics from the Centers for Disease Control and Prevention.

    "Virtually every tribal member has been adversely impacted by the opioid epidemic," the tribe said. "This epidemic has been growing for years and the effects of this crisis have only been exacerbated by defendants' efforts to conceal and minimize the risks of opioid addiction. The Ponca Tribe has seen its health care services overwhelmed and its costs to provide a wide range of social services, from child welfare to behavioral health, skyrocket."

    The Ponca Tribe is seeking a jury trial and an unspecified amount of financial damages. The tribe also wants a judge to issue an injunction prohibiting drug manufacturers and distributors from engaging in "unfair or deceptive practices" and to order them to form an "abatement fund" to combat the "opioid nuisance."

    Drug manufacturers issued statements Tuesday acknowledging that opioid abuse is a serious health issue, but denying wrongdoing.

    "Our actions in the marketing and promotion of these medicines were appropriate and responsible," said Jessica Castles Smith, spokesperson for Janssen Pharmaceuticals Inc. "The labels for our prescription opioid pain medicines provide information about their risks and benefits, and the allegations made against our company are baseless and unsubstantiated. In fact, our medications have some of the lowest rates of abuse among this class of medications."

    John Puskar, director of public affairs for Purdue Pharma LP, said his company vigorously denies the allegations made against it and looks forward to presenting its defense.

    "As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge," Puskar said.

    To help combat addiction, Puskar said his company has "developed three of the first four FDA-approved opioid medications with abuse-deterrent properties."

    Puskar said his company also reduced its sales by more than 50 percent a few weeks ago and has informed prescribers that field sales representatives no longer will be visiting offices to engage in discussions about opioid products.

    “We have restructured and significantly reduced our commercial operation and will no longer be promoting opioids to prescribers,” he said.

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Broadcast Media Coverage

22. North Coast News at 11PM

    Mar 14, 2018 | Eureka, CA

    By KAEF (ABC)

    Video Link: http://app.criticalmention.com/app/#clip/view/33560572?token=edcfbe92-57d9-4710-8403-35bac4a7a702

    Rough Transcript: now to the local fight against the opioid crisis. the yurok tribe says they've filed a lawsuit... against big pharmaceutical companies.... that are allegedly responsible for the surging opioid epidemic in the u.s -- and on the yurok reservation. the complaint alleges that 20 pharma comapanies violated a "197 racketeering act." 2:17 AM the defendants -- ranging from purdue pharma -- to johnson and johnson. it includes both manufacturers and distributors of opiate-based drugs... end end vo nazy the tribe says the yurok reservation sits at the epicenter of the country's opioid crisis -- in both humboldt and del norte counties. and they say humboldt -- is one of the first counties in the entire nation... that has had crisis- level overdose rates -- for over a decade. the yurok tribe's complaint also alleges that big pharma concealed important facts -- about the dangers of opioids... end end on cam nazy purdue pharma released the following statement in response to the opioid epidemic. they say they're troubled by opioidabuse... and are dedicated to being part of the solution... vidbox nazy saying quote... "as a company grounded in science... we must balance patient access to fda-approved medicines... while working collaboratively to solve this public health challenge. vidbox nazy although our products account for less than 2% of the total opioid prescriptions... developed 3 of the first four fda- approved opioidmedications with abuse-deterrent properties... and partner with 2:18 AMlaw enforcement to ensure access to naloxone... we vigorously deny these allegations... and look forward to the opportunity to present our defense" -- end quote. end end tsot "addiction is a disease we know this. we know how to treat it. we just have to put the programs in place in order to start taking care of this cris." contvo nazy the staggering statistic -- alcohol and other drug- related death rates are on the rise right here in humboldt county... end end on cam nazy that's according to a report prepared by humboldt county sheriff's and coroner's office. i sat down with the chief deputy coroner... to get to break down the numbers -- and discuss solutions... pkg end end "we investigate all unattended deaths within humboldt county." chief deputy coroner lt. ernie stewart -- seeing an upward trend in alcohol and drug- related deaths... over his decades- long career -- with the humboldt county sheriff's office. "methamphetamine is still the number one used illicit drug in our community." the humboldt 2:19 AMcounty department of health and human services -- reviewed the report released in february. it sheds light on the hidden history -- of humboldt's rising drug problem. "for most of the country, opiods have surpassed and overtaken meth. here, meth is just, it's engrained in the community." and while the public is paying more attention right now to the nationwide opiod epidemic... stewart says... "in humboldt county methamphetamine ultimately ends up killing more people than any of the other drugs in our community." and the grim reality -- is that these death rates have been rising each year. according to the recent report in 2017... out of 272 unattended deaths -- 49 were because of alcoh and other drugs. and those were just cases where the sheriff's office was called to respond... it doesn't include deaths of people under doctor's care. that's up from 43 in 2016 -- and 41 in 2015. of 2017's 49 deaths... 4 percent of deaths were from drugs and other causes... 8 percent were from drugs and alcohol... 18 percent were due to multi-drug toxicity... 20 percent were because of alcohol... 21 percent were from opioids... and the largest amount -- 29 percent -- were due to methamphetamine or stimulants. "it's been number one for a long time, and i think opioids are catching up, but they haven't surpassed it yet." stewart saying -- more funding for mental health services -- will help bring down overdose death rates. "until we find ways to fund those services to the extent that they need to be, we're going to continue to see, our numbers for the drug overdose deaths, suicide deaths, they're going to continue to rise until we address the issue." end end on cam nazy if you're interested in reading the full report... we will post it for you -- on our website. end end stinger topvo nazy still ahead on north coast news.

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23. Good Morning Utah

    Mar 14, 2018 | KTVX (ABC)

    By KTVX (ABC)

    Video Link: http://app.criticalmention.com/app/#clip/view/33560588?token=edcfbe92-57d9-4710-8403-35bac4a7a702

    Rough Transcript: summit county is taking a big step against opioid addiction and abuse... the coty council voted this week to authorize the county to file a lawsuit against opioid manufacturers on behalf of the public. across the country more than 250 lawsuits have been filed against big pharma companies... communities seeking damages due to the costs of the opioid cris. summit county attorney margaret olson expects more counties in utah to file similar suits. [d17]health alert wipe-server brian in a health alert this morning... easy access to naloxone is saving lives. that's the message from the utah department of health. the rescuerug reverses an overdose, and it's been widely distributed through local pharmacies. a law passed last year providing a so called standing order by the health department. it allows pharmacists to provide naloxone without a prescription. angela ito, udoh opioid prevention coordinator, "it gives me hope -- pharmacies are taking an active role in this epidemic we put a lot of pressure on doctors to stop prescribing we put a lot of pressure on the public to be aware and not ask for we know the pharmacies are the last touch before that customer go home with that medication brian last year pharcists dispensed more than 42-hundred doses of naloxone.

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24. 12 News at 6am

    Mar 14, 2018 | Clarksburg, WV

    By WBOY (NBC)

    Video Link: http://app.criticalmention.com/app/#clip/view/33560594?token=edcfbe92-57d9-4710-8403-35bac4a7a702

    Rough Transcript: taylor and barbour counties are suing drug manufactures and wholesalers over opioids. barbour county commission has retained a collection of law firms to handle the lawsuit. officials say the county has become ground zero for the opioid epidemic. they say the companies being sued have distributed more than five million doses of oxycodone and hydrocodone in barbour county from 2007-2012.

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25. Good Day Alabama 4:00am

    Mar 14, 2018 | Birmingham, AL

    By WBRC (Fox)

    Video Link: http://app.criticalmention.com/app/#clip/view/33560597?token=edcfbe92-57d9-4710-8403-35bac4a7a702

    Rough Transcript: several local governments have gone after drug manufacturers for contributing to the opioid epidemic. ...and now shelby county has joined in that legal fight for it's citizens. clare huddleston joins us now live with that story, so clare who are they going after? they are going after the drug manufacturers who make these opioids. they are hoping to change the way the drugs are created and distributed. attorneys in shelby county say they're suing because of the growing cost of combating the opioid addiction. county leaders say this epidemic will impact everyone for generations to come - mainly because it's wiping out so many young people. opioids are also impacting law enforcement officils because it can be deadly if they come into contact with some of these opioids. still, the main drive for this lawsuit is the impact on families. alan miller/compact 2020: "the adictio has a devastating impact on families. families try to handle this on their own and they don't know where to seek help." shelby county leaders say it's going to take education, law enforcement and treatment to fight the war against opioid abuse. they're hoping this legal batle is one step in the right direction.

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26. 18 News at Noon

    Mar 13, 2018 | Elmira, NY

    By WETM (NBC)

    Video Link: http://app.criticalmention.com/app/#clip/view/33560636?token=edcfbe92-57d9-4710-8403-35bac4a7a702

    Rough Transcript: schuyler county plans to sue big pharma..for its role in the opioid epidemic.. overdose numbers in the county are increasing.. and local lawmakers blame big pharmaceutical companies...for dishonest marketing. 18 news reporter brook taylor reports: nat schuyler county plans to sue big pharma.. the county blames their dishest marketing for the opioid crises... legislators want reimbursement for the abuse cost... between social services..treatment..and law enforcement.. nat 12:05 PMelizabeth grieco came to the public hearing.. to share her sons battle with the addictive drug.. greico "i found him laying on his bed.. i tried to revive him..called the ambulance..the last thing i seen of him going out of the house was they had a machine on him making him breath..it was just horrible." despite treatments..griecosays the addiction took over... greico "he was an addict for 9 years..he fought it really hard..he kept coming out of rehab. he has a 7 year old daughter so he wanted to be clean for her." schuyler county attorney... steven getman.. says big pharmaceutical companies have hooked an entire generation..and tax payers shouldnt be paying the price.. getman: "there's an increasing body of evidence that big pharmaceutical companies have deceptively manufactured..advertised..and marketed opioids..and encouraged health care providers to over provide." most recently... one head of big pharma..martin shkrelli was sentenced to seven years in prison for deceptive marketing... and inflating drug prices.. getman says any dollar won frombig pharma is a dollar that stays in county government to fund existing treating programs.. for greico..it's a great first step..but she says suing big pharma shouldnt be onl greico "we have treatment centers now....they're in there for 6 months and then out ..half way houses..they don't pay atention..my son using half way house..its not good enough" brooke taylor..18 news.. schuyler county isn't the only new york county to sue big pharma. at least 14 other counties across the state have also filed suit.

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