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Opioid Litigation Daily Media Report -3/26/18
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Trump Says Fed. Gov't Will Sue Drugmakers Over Opioids
Mar 23, 2018 | Law360
By Emily Field
U.S. President Donald Trump on Friday said the federal government will be suing “certain” drug companies over the opioid crisis, without naming which ones or going into further detail. -
Trump pledges to sue drug companies over opioids
Mar 23, 2018 | Reuters
By Staff
U.S. President Donald Trump on Friday said his administration will be suing some drug companies as part of its fight against the opioid drug crisis, without giving more detail. -
Federal budget deal includes $4.6 billion to combat opioid epidemic
Mar 25, 2018 | Associated Press
By Geoff Mulvihill
The federal government will spend a record $4.6 billion this year to fight the nation’s deepening opioid crisis, which killed more than 42,000 Americans in 2016. -
TRANSNATIONAL CRIMINAL ORGANIZATIONS AND THE OPIOID CRISIS TO BE EXAMINED AT HELSINKI COMMISSION BRIEFING
Mar 22, 2018 | Commission on Security & Cooperation in Europe
The Commission on Security and Cooperation in Europe, also known as the Helsinki Commission, today announced the following briefing: -
Trump opioid plan writes in favoritism to single company’s addiction medication
Mar 26, 2018 | STAT News
By Lev Facher
The White House’s national strategy to combat the opioid crisis, unveiled last week, would expand a particular kind of addiction treatment in federal criminal justice settings: a single drug, manufactured by a single company, with mixed views on the evidence regarding its use. -
Opioid lawsuit is misguided (Letter to the Editor)
Mar 25, 2018 | Park Record (UT)
By Staff
The leading causes of death for Utahns include heart disease and diabetes, so why isn't Summit County suing the makers of salty and sugary foods that have no nutritional value? Cancer and respiratory disease are also major Utah killers, but I don't see law suits being proposed for producers of cigarettes, cars, or other air polluters. Why aren't alcoholic beverage manufacturers being sued for all of the alcohol related disease, traffic accidents, family strife and fatalities caused by people who abuse alcohol? -
State Opioid Taxes Seen As Well-Intentioned But Misguided (Opinion)
Mar 23, 2018 | Matthew Nesto
By Matthew Nesto
Facing a mounting death toll, soaring costs and growing public anger over the opioid crisis, an increasing number of states are considering new laws that would tax the powerful painkillers, despite concerns that some states may be using the crisis to raise general revenue. -
Blaming doctors for opioid crisis is easy, but not the whole story (Opinion)
Mar 25, 2018 | Ocala Star Banner (FL)
By Fred Hiers
When the number of national opioid deaths swelled, people quickly pointed to physicians and their prescription pads as the culprits. -
Shortage of legal opioids needs to be addressed (Opinion)
Mar 25, 2018 | The Buffalo News (NY)
By Editorial Board
The prospect appalls Senate Minority Leader Charles E. Schumer: People – sometimes children – suffering unnecessary pain after surgery or while undergoing cancer treatments, simply because of “bureaucratic finger-pointing and lack of timely and effective action.” He wants the U.S. Drug Enforcement Agency to lift production quotas that may be limiting the supply of legal opioids used nationwide. It is exactly what should happen. -
OPIOID CRISIS: IS ARKANSAS PAVING THE WAY FOR BIG PHARMA, NOT TAXPAYERS, TO PAY FOR ADDICTION?
Mar 26, 2018 | Newsweek
By Nicole Goodkind
A group of cities and counties across Arkansas are uniting to sue 65 opioid makers and distributors, arguing that those companies should pay for the the costs of drug abuse and addiction to their state. -
City suing defendants who would rather stay out of court
Mar 26, 2018 | Jacksonville Daily Record (FL)
By Max Marbut
The defendants named in the City of Jacksonville’s opioid lawsuit are well-versed in the litigation process, particularly when it comes to settling matters instead of appearing in court. -
Bay, P.C. opioid cases tied in to national suit
Mar 26, 2018 | Panama City News Herald (FL)
By John Henderson
Bay County’s and Panama City’s opioid lawsuit against pharmaceutical companies is now part of a massive national legal case before a judge in Ohio. -
County plans response to opioid crisis
Mar 24, 2018 | Northeast Georgia News (GA)
By Diana Wagner
The Floyd County Commission is preparing to establish a community board to address the problems of opioid addiction. -
Bainbridge, Hospital Authority join opioid lawsuit
Mar 23, 2018 | The Post Searchlight (GA)
By Carolyn Iamon
Members of Memorial Hospital and Manor Authority voted at their monthly meeting Tuesday afternoon to participate with the City of Bainbridge and Decatur County Commission in the Opioid class action lawsuit being filed by the law firm of Blasingame, Burch, Garrard & Ashley, PC. against the pharmaceutical companies that manufacture opioids. The vote was far from unanimous. There were three yeas and three nays, with Authority President Glennie Bench, breaking the tie with a yes vote. -
ATTORNEY FILES FEDERAL LAWSUIT AGAINST DRUG MAKERS
Mar 23, 2018 | WDEF (TN)
By Collins Parker
Governmental agencies at the federal and state level are launching dozens of programs to deal with the opioid crisis in this country. -
Pasquotank may join opioid lawsuit
Mar 24, 2018 | Daily Advance (NC)
By Jon Hawley
Pasquotank County officials are considering joining national litigation against opioid manufacturers and distributors — litigation that if successful could help Pasquotank defray its costs responding to the crisis that addiction to the drugs is causing. -
Two municipalities sue over opioid crisis
Mar 26, 2018 | Virginia Lawyers Weekly (VA)
By Matthew Chaney
Two Virginia localities are suing more than 30 pharmaceutical companies they say are responsible for opioid epidemics in their communities. The City of Alexandria and Dickenson County filed lawsuits against manufacturers, distributors and pharmacy benefit managers March 14. The local governments claim they are suing to recoup financial losses from “the public health emergency caused by prescription. -
Mashpee Considers Joining Pharmaceutical Opioid Lawsuit
Mar 23, 2018 | The Mashpee Enterprise (MA)
By Sam Houghton
The Mashpee Board of Selectmen has considered joining a lawsuit filed by hundreds of towns and cities across the country looking to recoup financial losses caused by the opioid epidemic. -
Morrisville agrees to sue opioid companies
Mar 23, 2018 | The Intelligencer (PA)
By Thomas Friestad
Morrisville is entering a nationwide legal fray against major pharmaceutical companies. -
El Paso County asked to join opioid lawsuit against pharmaceutical giants
Mar 24, 2018 | The Gazette (CO)
By Rachel Riley
El Paso County has been asked to join hundreds of cities and counties that are suing major pharmaceutical companies, blaming them for exacerbating a nationwide epidemic of opioid abuse and overdoses and demanding compensation for the costs. -
Utah’s attorney general says a lawsuit over opioids is drafted, but he’s not filing it yet
Mar 26, 2018 | Fox 13 (UT)
By Ben Winslow
Utah Attorney General Sean Reyes has drafted a lawsuit against "Big Pharma" over the opioid crisis. -
Geauga County files lawsuit to help fight opioid epidemic
Mar 23, 2018 | The News-Herald (OH)
By Tracey Read
Geauga County has officially filed a federal lawsuit against opioid manufacturers and distributors to help offset a dramatic increase in costs for law enforcement, addiction treatment and overdose prevention because of the drug epidemic. -
South Bend files lawsuit against opioid companies
Mar 23, 2018 | South Bend Tribune (IN)
By Lincoln Wright
The City of South Bend officially filed its federal lawsuit against the manufacturers and distributors of prescription opioids, arguing the companies played a role in the city's drug epidemic. -
City Weighs Costs, Benefits of Going After Big Pharma
Mar 26, 2018 | Rivard Report (TX)
By Roseanna Garza
As the City of San Antonio considers whether to join a class action lawsuit against opioid manufacturers and distributors for their alleged role in a crisis that has been devastating locally, City officials must weigh the benefits and the costs of what can become lengthy, and costly, legal action. -
WDVM News at 10:00PM
Mar 26, 2018 | Washington, D.C.
By WDVM (WDVM)
Video Link: http://app.criticalmention.com/app/#clip/view/33835956?token=dacd3025-e9e0-48bc-91c5-e6af825ef148 -
Boston 25 News at 10PM
Mar 26, 2018 | Boston, MA
By WFXT (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33835978?token=dacd3025-e9e0-48bc-91c5-e6af825ef148 -
Capitol View
Mar 25, 2018 | Springfield, MO
By KOZL (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33835967?token=dacd3025-e9e0-48bc-91c5-e6af825ef148
President Trump Press Conference
Commentary and FYIs
Southeast (AR, FL, GA, TN, NC, VA)
Northeast (MA, PA)
West (CO)
Midwest (OH, IN)
Southwest (TX)
Broadcast Media Coverage
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Trump Says Fed. Gov't Will Sue Drugmakers Over Opioids
Mar 23, 2018 | Law360
By Emily Field
U.S. President Donald Trump on Friday said the federal government will be suing “certain” drug companies over the opioid crisis, without naming which ones or going into further detail.
The president said the government would be suing drug companies at the federal level during a press briefing following his signing of a $1.3 trillion spending and policy bill that narrowly averted a government shutdown. The bill includes about $4 billion to fight the ongoing opioid crisis, which took the lives of an estimated 42,000 Americans in 2016.
“The level of drugs that are being put out there and the power of this addiction is hard to believe,” Trump said. “People go to the hospital for a period of a week and they come out, they’re drug addicts. There has to be a better way.”
Trump had publicly considered vetoing the bill, tweeting earlier on Friday that the bill did not provide enough border wall funding or do enough to address the situation of Deferred Action for Childhood Arrivals program recipients, but ultimately signed it despite his complaints about the process. The amount of funding for the military, some $700 billion, overrode his other concerns, Trump said.
Trump also indicated that some of the funding would go to developing nonaddictive pain treatment.
“We’re also looking for in our research funds, we’re looking for a medicine that can stop the pain without the addiction, so that people aren't going to become addicted to these incredible drugs,” Trump said.
On March 19, Trump released a four-part plan for curbing the crisis with a range of policies, including a controversial plan to seek the death penalty for certain drug traffickers.
The blueprint, which Trump outlined during a speech in New Hampshire, largely reflected recommendations advanced last year by a presidential commission. The plan includes tougher criminal enforcement, stricter border security, expanded addiction treatment and a nationwide educational campaign.
Trump has previously hinted at bringing litigation against some drug companies over the opioid crisis, both in the New Hampshire speech and in remarks earlier this month.
While many observers have applauded his interest in taking legal action against the drug industry, his idea of imposing the death penalty on drug traffickers has garnered less support. In a statement March 19, the American Civil Liberties Union called the proposal “unconstitutional and absurd.”
Two days after Trump’s New Hampshire speech, U.S. Attorney General Jeff Sessions released a memo directing federal prosecutors to seek the death penalty in “appropriate cases” involving drug trafficking.
One component of Trump’s plan focuses on reducing demand and improper prescribing. The president set a goal of reducing opioid prescriptions by one-third within three years and ensuring that 95 percent of government-reimbursed opioid prescriptions are prescribed in accordance with best practices within five years.
Trump also backed a public advertising campaign to “scare” Americans away from abusing opioids, and he rolled out a website — crisisnextdoor.gov — that invited Americans to share personal stories related to opioid abuse.
A third component of the president’s vision emphasized help for people struggling with addiction. Trump endorsed wider availability of overdose-reversal drug naloxone and more opportunities for drug offenders to enroll in treatment programs as an alternative to incarceration, among other initiatives. -
Trump pledges to sue drug companies over opioids
Mar 23, 2018 | Reuters
By Staff
U.S. President Donald Trump on Friday said his administration will be suing some drug companies as part of its fight against the opioid drug crisis, without giving more detail.
Rough Transcript: “We’ll be suing certain drug companies for what they’ve done with the opioids and we’ll be bringing suits at a federal level,” Trump told reporters at the White House days after outlining several steps to combat the epidemic.
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Federal budget deal includes $4.6 billion to combat opioid epidemic
Mar 25, 2018 | Associated Press
By Geoff Mulvihill
The federal government will spend a record $4.6 billion this year to fight the nation’s deepening opioid crisis, which killed more than 42,000 Americans in 2016.
But some advocates say the funding included in the spending plan President Trump signed Friday is not nearly enough to establish the kind of treatment system needed to reverse the crisis. A White House report last fall said the overdose epidemic cost the U.S. economy more than $500 billion in 2015.
Former congressman Patrick J. Kennedy (D-R.I.), who served on Trump’s opioid commission last year, said there are clear solutions but Congress must devote more money to them.
“We still have lacked the insight that this is a crisis, a cataclysmic crisis,” he said.
By comparison, the Kaiser Family Foundation found that the United States is spending more than $7 billion annually on discretionary domestic funding on AIDS, an epidemic with a death toll that peaked in 1995 at 43,000.
States also have begun putting money toward the opioid epidemic. The office of Ohio Gov. John Kasich (R) estimates that the state is spending $1 billion a year to address the crisis. Last year, New Jersey allocated $200 million to opioid programs, and the budget proposal in Minnesota calls for $12 million in the coming fiscal year.
A spokesman for Massachusetts Gov. Charlie Baker (R), who also served on Trump’s panel, said the government must do more.
“Governor Baker encourages members of Congress to work together on a plan forward to fully fund the bipartisan recommendations,” spokesman Brendan Moss said.
The commission’s chairman, former New Jersey governor Chris Christie (R), declined through a spokesman to comment.
The opioid allocation is part of the $1.3 trillion budget appropriation Trump signed Friday. In a budget deal full of compromises, this was one element both parties heralded.
The budgeted amount is about three times as much as the government is currently spending to address the epidemic, not counting treatment money that flows through Medicaid and Medicare.
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Mar 22, 2018 | Commission on Security & Cooperation in Europe
The Commission on Security and Cooperation in Europe, also known as the Helsinki Commission, today announced the following briefing:
THE OPIOID CRISIS AND THE DARK WEB:
HOW TRANSNATIONAL CRIMINALS DEVASTATE U.S. COMMUNITIESWednesday, March 28, 2018
3:30 p.m.
Russell Senate Office Building
Room 485Live Webcast: www.facebook.com/HelsinkiCommission
The opioid crisis is devastating the health and well-being of Americans. Following a dramatic increase in the use of prescription opioid painkillers in the late 1990s, the crisis now kills more than 40,000 people in the United States annually. Experts estimate that millions more abuse prescription opioids each year, many of whom later turn to heroin.
Transnational criminal organizations are one of the driving forces behind the intensity of the opioid crisis. By taking advantage of anonymous online marketplaces and legal delivery services, they can smuggle deadly drugs like fentanyl into the United States in a low-risk, high-reward way.
This briefing will trace the criminal networks that produce these drugs, market them on the dark web, and smuggle them into the United States to better understand how the public and private sectors can more effectively respond to this crisis and save thousands of American lives.
The following panelists are scheduled to participate:Kemp Chester, Associate Director of the National Heroin Coordination Group, Office of National Drug Control PolicyJohn Clark, Vice President and Chief Security Officer, Global Security, Pfizer Inc.Louise Shelley, Director, Terrorism, Transnational Crime, and Corruption Center (TraCCC); Professor, George Mason University
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Trump opioid plan writes in favoritism to single company’s addiction medication
Mar 26, 2018 | STAT News
By Lev Facher
The White House’s national strategy to combat the opioid crisis, unveiled last week, would expand a particular kind of addiction treatment in federal criminal justice settings: a single drug, manufactured by a single company, with mixed views on the evidence regarding its use.
Federal prisons should “facilitate naltrexone treatment and access to treatment” to inmates as they transition out of incarceration, according to a fact sheet circulated by the administration. A White House spokesman later confirmed to STAT that the document referred specifically to naltrexone in its injectable form.
Only one manufacturer makes a drug fitting that description: Alkermes, a Massachusetts pharmaceutical company that makes Vivitrol, a monthly injectable drug that blocks the effects of opioids and reduces cravings. The company has been criticized for aggressive tactics in pitching its product — which can cost over $1,000 per dose — to criminal justice systems. In November, Sen. Kamala Harris (D-Calif.) opened an investigation into the company’s marketing practices.
The federal prison system oversees roughly 185,000 inmates, and some estimates indicate that nearly half meet criteria for a substance use disorder. The plan, according to the White House spokesman, was to use Vivitrol to provide a month of reduced risk for relapse before transitioning individuals into longer-term recovery. The spokesman later added that the policy objective was to save lives and not to punish the pharmaceutical industry.
But addiction experts say that, though ensuring access to medication-assisted treatment (MAT) is an improvement on status quo, multiple MAT drugs should be made available and chosen according to physician judgment and patient need.
Criminal justice systems have often favored naltrexone since it is not opioid-based and not a potential drug of abuse, as are true of methadone and buprenorphine. Alkermes CEO Richard Pops, when testifying before a White House commission on the opioid crisis in September, stressed the importance of increasing insurance coverage for Vivitrol, but added that patients should be made aware of all available treatment options.
When asked about the plan, administration health officials themselves expressed doubts about the approach.
“We don’t per se favor one drug over the other, because some patients respond better to one or the other,” said Nora Volkow, the director of the National Institute on Drug Abuse, at a press event on Tuesday. “It is clear that treatment in the prison system significantly improves outcomes, whether it’s [with naltrexone or buprenorphine].”
Health secretary Alex Azar was unfamiliar with the proposal to provide Vivitrol exclusively, saying in response to a STAT question: “I have a feeling that was an inadvertent reference. I think the key thing was the prison population, as opposed to any one product.”
Azar, who was sworn in as health secretary in late January, walked back his remark 15 minutes later, citing “staff-level discussions” and a directive from the Substance Abuse and Mental Health Services Administration that anyone “coming out of prison or a detox program should in fact be put on naltrexone, but that doesn’t mean it’s the best form [of MAT] for all populations.”
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Opioid lawsuit is misguided (Letter to the Editor)
Mar 25, 2018 | Park Record (UT)
By Staff
The leading causes of death for Utahns include heart disease and diabetes, so why isn't Summit County suing the makers of salty and sugary foods that have no nutritional value? Cancer and respiratory disease are also major Utah killers, but I don't see law suits being proposed for producers of cigarettes, cars, or other air polluters. Why aren't alcoholic beverage manufacturers being sued for all of the alcohol related disease, traffic accidents, family strife and fatalities caused by people who abuse alcohol?
People who abuse legal or illegal drugs only kill themselves, but people who abuse the right to bear arms are killing others. Why aren't gun manufacturers being held responsible for the death of hundreds of innocents?
Every tax-paying citizen in Summit County should be outraged that their hard earned dollars are being spent to avenge the death of people who kill themselves by misusing drugs, but not to avenge the death of people who are being killed by guns, drunk drivers, and all of the life-stealing foods and beverages that are advertised every day, starting in early childhood.
A lawsuit against Big Pharma will be costly, but do nothing to fix drug abuse or human behavior. Taxpayer dollars would be much better spent on preventive health education and services.
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State Opioid Taxes Seen As Well-Intentioned But Misguided (Opinion)
Mar 23, 2018 | Matthew Nesto
By Matthew Nesto
Facing a mounting death toll, soaring costs and growing public anger over the opioid crisis, an increasing number of states are considering new laws that would tax the powerful painkillers, despite concerns that some states may be using the crisis to raise general revenue.
According to the National Conference of State Legislatures, lawmakers in New York, New Jersey, Minnesota, Tennessee, West Virginia, Kentucky and half a dozen other states are currently mulling tax bills that look to offset some of the cost of fighting the deadly drug epidemic that killed more than 30,000 people in the U.S. last year.
Although this legislative approach to tax opioid manufacturers and distributors is still relatively small compared to the litigation route that is currently being pursued by several hundred cities, counties and states, it is nonetheless historic and not without controversy.
“Many of the solutions to the opioid crisis reside in between the government’s obligation to appropriate funds for the public welfare and the pharmaceutical industry’s obligations to use some of the profits generated by opioids toward these programs,” said Adam Fleischer, a partner with the Chicago firm BatesCarey LLP and chairman of the firm’s opioid coverage task force, via email.
“The idea to use taxes toward these ends is a recognition that solving the crisis is an issue of funding societal change as opposed to the more stagnant approach of simply compensating discrete harm, which is not what this is about,” he added.
One key area of concern, and a reason why no state has ever placed a tax on a legitimate, prescribed medication before, is the reality that it could interfere with the sacred nature of the doctor-patient relationship. Unlike similar taxes on cigarettes, alcohol or even soda, experts say any discouragement of a person’s ability to take their medicine is a dangerous precedent.
“A tax on opioids is a misguided approach,” said American Enterprise Institute’s Alex Brill, highlighting two unintended consequences. “First, it would burden patients who are rightfully prescribed and properly using opioids. Second, it may encourage those addicted to prescription opioids to switch to more dangerous alternatives such as heroin,"
There is also some question that such a levy might be illegal, given the opposition to provider taxes held by the Centers for Medicare and Medicaid Services, the federal overseer that accounts for 37 percent of national health expenditures.
Other industry watchers warn that if a state or local opioid tax was approved, there would be nothing to prevent it from spreading to a tax on antidepressants, insulin or any other medicine, if the intention was to address some underlying societal harm.
“Indiscriminately taxing prescribed medications that patients legitimately rely on for serious, debilitating and sometimes fatal conditions to make up budget shortfalls is a dangerous precedent to set, especially when it is being done under the guise of a public health crisis,” said Nick McGee, the director of public affairs for PhRMA, the Pharmaceutical Research and Manufacturers of America.
Although some states such as Minnesota specifically earmarked an estimated $20 million of opioid revenues to be used for treatment and prevention programs, other states, such as Kentucky, planned to use the proceeds to close a budget deficit. Either way, state and local officials are acutely aware of the range of costs opioid addiction and death are placing on them, and they are eager to recoup them as quickly as possible.
“Heroin and opioid use is a major public health and safety crisis and the cost to our community is not limited to pain and suffering of the individuals impacted,” New York State Association of Counties' President MaryEllen Odell said in a presentation this month at the National Association of Counties legislative conference in Washington. “Unfortunately, there is also a taxpayer impact, including massive resources used in public health, law enforcement, the court system, mental health and social services, coroner and medical examiner, and many other programs and services."
But even the process of evaluating costs is complex and challenging, since some studies include heroin and other illegal or counterfeit opioids in their overdose stats alongside those of prescribed medication, while other research reports attempt to place a societal cost or dollar value on the loss of a life.
To that point, a study published in early March by Brill showed the District of Columbia had the highest per-capita nonmortality costs, at $493, followed by New Hampshire at $360. But if estimated mortality costs are included, West Virginia’s per-capita opioid death expense soars to $4,378, followed by $3,657 in Washington, D.C., almost a tenfold increase.
“One key finding from our work is the fact that the impact of the opioid crisis is disparate by state,” Brill said. “In some places, high rates on misuse of these drugs drives up the community costs. In other places, such as California, the high cost of health care services is a driver behind relatively high per capita costs."
Still, with 11 opioid tax bills still pending, and another six already tabled or killed, one thing is clear: Efforts to fund this costly fight against opioids are far from over. -
Blaming doctors for opioid crisis is easy, but not the whole story (Opinion)
Mar 25, 2018 | Ocala Star Banner (FL)
By Fred Hiers
When the number of national opioid deaths swelled, people quickly pointed to physicians and their prescription pads as the culprits.
But recent studies say singling out the medical community won’t help to stem the opioid epidemic. And locally, doctors and healthcare professionals say the medical community’s performance doesn’t explain why Marion County is one of the leading communities in Florida when it comes to addiction, opioid abuse and death.
Here’s the popular national narrative: “Pill mill” doctors wrote thousands of prescriptions, flooding Florida streets with millions of opioid pills. People took some, sold others. Some people got addicted. In the mid-2000s, when law enforcement agencies and healthcare regulators started clamping down, opioid addicts turned to heroin.
And when heroin suppliers mixed deadly fentanyl or its deadlier analogs with the heroin and addicts died, many critics again pointed to doctors, whom they blamed for continuing to write prescriptions for opioids and thus perpetuating the cycle.
This past legislative session, Tallahassee lawmakers approved bills severely limiting the amount of time a doctor can prescribe opioids to a patient.
Meanwhile, the number of drug overdoses is swelling. By 2015, drug overdose was the leading cause of accidental deaths in the country, with 52,404, according to the American Society of Addiction Medicine. Opioid addiction had become the driving force behind the epidemic, with 20,101 overdose deaths related to prescription pain relievers and 12,990 overdose deaths related to heroin.
The country has been awash in opioids. In 2015, 300 million opioid prescriptions were written, according to the Harvard Law & Policy Review. According to national statistics, many of the people who used those opioids became addicted. Almost 80 percent of heroin addicts reported that they had first used opioid pain killers, according to the National Institute on Drug Abuse.
Someone addicted to opioid painkillers is 40 times more likely to abuse or develop an addiction to heroin than non-opioid users, according to the federal Centers for Disease Control and Prevention.
One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers, according to a new Washington Post-Kaiser Family Foundation survey.
Dr. David Willis, Heart of Florida’s former chief medical officer, said the opioid epidemic is more complex than statistics make out. And putting the blame on doctors won’t fix the problem.
“I would have to admit my profession has contributed but is not the main culprit in any shape or form,” Willis said.
To better understand the medical community’s role in the epidemic, Dr. David Brown wrote recently in The American Scholar, it is important to understand how pain management has changed in the past 30 years.
Beginning in the 1990s, doctors concluded that there was an epidemic of untreated pain among patients, especially surgical patients, patients with cancer, and the dying. As a result, doctors began aggressively giving those patients opioids to help their conditions.
Unfortunately, the idea of pain management also spread to patients with chronic pain. Eventually, pain and the measure of it became the “fifth vital sign” along with heart rate, respiratory rate, temperature and blood pressure.
• • •
Much of the rise in opioid prescriptions was predicated on a 1980 letter in the New England Journal of Medicine entitled “Addiction Rare in Patients Treated with Narcotics.” It noted that researchers studied 10,000 hospitalized patients treated with opioids for pain and that only four cases of addiction occurred.
Despite no clear explanation as to the methodology of its conclusions, the letter was cited more than 600 times, a more recent study found.
Patients also grew ever more demanding for pain relief. Over time, many hospitals even required that doctors learn about chronic pain control, Brown wrote in his American Scholar piece.
“We were pushed to make pain the fifth vital sign by (insurance and pharmaceutical companies, national quality measures, and the medical industry),” Willis wrote. “And many, many physicians got trained: Here’s this pain reliever. Use it.”
That set the stage, he said. Over time, opioid pills found their way onto on streets and into the hands of people who shouldn’t have them.
Willis describes the latest move to limit opioid prescriptions as “an onerous legislative practice of medicine.” He predicts that in the near future the only doctors who will be writing opioid prescriptions will be chronic pain and addiction specialists. The problem is, there are not enough of them.
Willis said doctors “got a bad rap” for causing the opioid epidemic “and a bad rap for not treating pain” before opioids were readily used. He warns that limiting opioid prescriptions won’t solve the country’s drug problems.
Regardless of how much heroin and fentanyl is taken off the streets, “I think addicts will find something else,” Willis said.
• • •
The latest studies of the opioid crisis suggest that the narrative of naïve opioid patients getting addicted to their prescriptions, or worse, moving on to heroin and fentanyl, is mostly not true. Indeed, according to Willis, the notion that your local doctor is the cause for the continued heroin and fentanyl addiction is a function of misguided media hype, not facts.
About 70 percent of Americans are prescribed medical opioids at least once during their lifetime. If as many get addicted and move on to heroin as some studies suggest, there would be tens of millions of opioid addicts and hundreds of thousands of overdoses annually. But there are not.
Instead, recent studies say that few people who get hooked on painkillers move on to heroin. Fewer than 4 percent of people who misused prescription pain medicines started using heroin within five years, according to a Substance Abuse and Mental Health Services Administration study.
One 2016 review for the New England Journal of Medicine determined that among people taking opioids long term, “rates of carefully diagnosed addiction have averaged less than 8 percent in published studies.”
Another 2016 review of studies in JAMA, a peer-reviewed medical journal published by the American Medical Association, showed that most surgery patients weaned off painkillers without trouble.
Of more than 640,000 surgical patients who had never previously taken opioids, few used the drugs for more than three months after recovering from surgery. Rates varied from less than 0.12 percent for women who had C-sections up to 1.4 percent for patients who had knee surgery, the JAMA review showed.
Willis said that if doctors were the culprit behind the heroin addictions, the opioid-to-heroin cycle should have been broken once law enforcement and healthcare regulators began closing the pill mills. But it hasn’t been.
• • •
Data collected by the University of Florida also shows that while Marion County has a disproportionately high number of opioid overdoses, it has a low proportionate number of prescriptions written for them.
In 2015, doctors wrote 1,099 opioid prescriptions in Marion County per 100,000 residents living here, according to the Florida Drug-Related Outcomes Surveillance and Tracking System, which was created by the University of Florida College of Medicine.
During that same year, doctors in Putnam County wrote nearly 1,600 opioid prescriptions per 100,000 residents. Doctors in Citrus County wrote 1,372 opioid prescriptions per 100,000 residents, Levy County doctors wrote 1,305 opioid prescriptions per 100,000 residents.
David Houck is the pastor of Salt Life Church in Salt Springs. Many of the people he helps are drug addicts living in the Ocala National Forest.
He said before he became educated the opioid epidemic, many of the Marion County locals he knew would ask him for a ride outside the county to get a prescription filled.
“They were doctor shopping,” he said, adding that at the time he was too naïve to know what was happening.
“They’re traveling outside the county all the time,” he said. “It’s an economy.”
For each couple of prescriptions they get filled, they may sell one and use one, he said.
“You wouldn’t believe how smart addicts are,” Houck said.
He also doesn’t think doctors are solely at fault for the epidemic.
“There’s always going to be a gateway drug. People will always find a way,” he said.
When it comes to opioid painkillers, most people abusing opioids and surveyed by the Center for Behavioral Health Statistics and Quality, said they weren’t getting opioids from their doctors.
In a 2014 study, researchers found that more than 50 percent of opioid abusers reported they got their drugs for free from friends or relatives, 11 percent said they bought them from friends or relatives, and 4.4 percent said they stole them from friends or relatives. Only 4.8 percent said they bought them from a drug dealer or a stranger.
People who have doctor-prescribed opioids don’t tend to use them all. Between 42 percent and 71 percent of prescribed opioids go unused, according to a recent JAMA review of other studies.
Dr. Mike Jordan is executive director of the Marion County Children’s Alliance, which hosts the Marion County Heroin/Opioid Task Force.
Jordan said that closing the pill mills and urging doctors to write fewer prescriptions will take prescriptions off the street. But there will also be unintended side effects. Closing off the supply of opioids will drive more people to heroin.
“And they want a stronger high and heroin is cheaper as opioids are less available,” he said.
Jordan fears that the opioid, heroin, and fentanyl problem is complex with no easy answers. The problem is rooted in socioeconomic issues.
“Once you start down that trail (of drug use) you reach critical mass ... and you get totally out of control,” he said of drug use.
At least with prescription opioids drug abusers knew what was in them and their potency, he said.
Society needs to work on getting people to not start using illegal drugs from the start, he said.
“This is a temporary problem. We’re dealing with heroin and opioids today. But there will be a replacement,” Jordan said.
Rather than putting blame on doctors for the opioid epidemic, Jordan thinks society should look at the issues that are really fueling the problem.
While Jordan said he can’t cite specifics as to why Marion County has high incidences of drug use and overdoses, there are social issues to consider.
“When you have low levels of education, high poverty, and high incidences of single (-parent) families, then there’s a disruption to family life and little parental supervision,” he said.
“These are all sociological questions that are hard to answer,” he said.
The answer is for Marion County to educate people about the dangers of opioids and fentanyl and focusing on making treatment available to those who want it.
“At least as a community we’re trying to come together,” he said.
• • •
But many who ask for addiction help will not get it as soon as they want.
Most of Marion County’s addicts go to The Centers for addiction help. The publicly funded facility has 50 rehabilitation beds and six detox units.
Steve Blank is The Centers’ vice president of outpatient services. He notes that The Centers gets state money to provide in-house rehabilitation services for those without health insurance. The Centers also gets state money to keep the insured if they need to stay longer than their insurance will pay for.
Most in-patient rehabilitation clients stay three to six months. The Centers provides group and individual therapy and encourages them to attend 12-step addiction programs.
There are about 40 clients in the in-patient rehabilitation facility at any given time, Blank said. For every 100 in-patient clients accepted into rehabilitation, 20-30 are turned away, he said.
State funds don’t go far enough to cover everyone who asks for in-patient care, Blank said. In those cases, The Centers offers them space if they can afford to pay. The cost is $6,000 to $8,000 per month, still a fraction of what local private facilities charge. Most of The Centers’ in-patient rehabilitation clients do not have insurance, Blank said.
Outpatient is best suited for drug users who do not use every day, often still have jobs and family support.
Blank said that society shouldn’t expect an easy fix and looks at opioid and cocaine addiction as a disease.
“It’s a little more than just saying no to opioids,” he said.
And for now it’s still easy to get heroin and it’s cheap, he said. The risk of the heroin being laced with deadly fentanyl will not keep people from using it.
In a written statement to the Star-Banner, Florida Sen. Dennis Baxley warned that there may be consequences as doctors cut back on prescriptions.
“I am concerned that we may be headed for a backlash as when we cracked down on pill mills,” he wrote. “There must be a strong preemptive strike to avoid addiction, but it may get very tough on those who need pain medication.”
Part of the solution is that “we must provide more addiction treatment slots and early on in the addiction process,” he said.
In addition, “we must provide much more graphic warnings of devastating consequences of addiction in public service announcements, much as we have with other hazardous behaviors,” he said.
Blank estimates that about 1 in 3 of his patients will get and remain clean.
As for why Marion County has such high incidences of drug use and overdose, Blank responded, “How many? Why and higher in some counties may not be the right question ... now.”
“This (addiction) problem is here,” he said. “It’s not going away.”
“We can’t arrest our way out of it,” he said. “It’s about education and prevention ... and not ‘just say no.’”
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Shortage of legal opioids needs to be addressed (Opinion)
Mar 25, 2018 | The Buffalo News (NY)
By Editorial Board
The prospect appalls Senate Minority Leader Charles E. Schumer: People – sometimes children – suffering unnecessary pain after surgery or while undergoing cancer treatments, simply because of “bureaucratic finger-pointing and lack of timely and effective action.” He wants the U.S. Drug Enforcement Agency to lift production quotas that may be limiting the supply of legal opioids used nationwide. It is exactly what should happen.
As News Washington bureau chief Jerry Zremski wrote, the situation affects Roswell Park Comprehensive Cancer Center, among others. Candace S. Johnson, chief executive officer, spoke of the cancer patient as collateral damage, adding that the result could be a “national disaster.”
The cause for concern: the shortage of premeasured doses of hydromorphone, morphine and other injection opioids that doctors in hospitals and hospices use to treat pain caused by some cancers and traumatic injuries.
Roughly 80 percent of Roswell Park’s 125 cancer patients rely on opioids to manage intense pain caused by many cancers. Roswell Park pharmacists have been mixing, dividing up and repackaging opioids. It is a costly creative solution: nearing $2.7 million in 18 months.
Erie County Medical Center, the region’s level-one adult trauma center, in addition to “procuring supplies” is also compounding its own drugs, in the same manner as Roswell Park.
Doctors at the Center for Hospice & Palliative Care, which runs Hospice Buffalo, have been in the difficult position of deciding when to use opioids and when second-choice alternatives can be substituted. The shortage of injection opioids and patients who cannot take medicine orally results in some patients getting opioids delivered through the rectum.
Again, as Zremski’s article indicated, this is not just a local problem. Five national medical groups, led by the American Hospital Association, recently wrote to the DEA warning that should the shortage get any worse, medical care will be affected.
The shortage intensified when Pfizer, the main supplier of injection opioids, scaled back production at its plant in McPherson, Kan., last June. It coincided with an upgrade to its facility.
Another blow hit when one of Pfizer’s suppliers of a key component of its pre-filled syringes experienced a quality-control problem and, as a result, Pfizer placed a temporary hold on its shipment of all such products. It created a domino effect, as Pfizer controls the majority of the market for prescription opioids and other producers do not have the capacity to fill the void.
Rep. Brian Higgins, D-Buffalo, who is also leading the way on this issue and has sent a letter to the DEA, its inspector general and the Food and Drug Administration, is absolutely right when he says that there needs to be a balance between controls of supply and legitimate need.
The opioid crisis is real and demands close attention by government regulators. But governments must be careful not to create collateral damage among those suffering intense and chronic pain.
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OPIOID CRISIS: IS ARKANSAS PAVING THE WAY FOR BIG PHARMA, NOT TAXPAYERS, TO PAY FOR ADDICTION?
Mar 26, 2018 | Newsweek
By Nicole Goodkind
A group of cities and counties across Arkansas are uniting to sue 65 opioid makers and distributors, arguing that those companies should pay for the the costs of drug abuse and addiction to their state.
In an unprecedented move, the state of Arkansas, 72 counties and 210 cities representing 90 percent of Arkansas’s population have joined together to fight for what they say is billions of dollars in damages caused by the companies. And, advocates say, other states may follow suit.
“Though other lawsuits have been filed in federal courts across the country, Arkansas is the only state that has united in this fashion,” said Chris Villines, executive director of the Association of Arkansas Counties, wrote in a statement. “Instead of fighting and competing with each other on critically needed settlement dollars for our cities and counties, all of the cities and counties are working together to do what’s best for Arkansas.”
The model was born out of need, Don Zimmerman, Executive Director of the Arkansas Municipal League, told Newsweek. “Our state is small in population, we only have 3 million people," he explained. "Our largest city is Little Rock and that only has 200,000 people. Going together is the only way we can make an impact here.”
Fatal overdoses have increased in Arkansas by roughly 300 percent over the last 18 years; In that same period, opioid sales quadrupled. The state has the second highest rate of opioid prescribing in the country, behind Alabama. More prescriptions are filled in Arkansas each year than there are people.
The suit claims that opioid makers and prescribers purposely mislead Arkansans about the risks of long-term drug use and make deceptive statements to advertise the drugs.
Robyn Walters, a resident of Northwest Arkansas, lost two loved ones to Opioid overdose and supports the lawsuit. It doesn't make sense to punish the addicted, she told KFSM-TV. Instead she wants to see the companies making and distributing the drugs punished. “They’re basically legal drug dealers and they need to be held accountable for what they are doing and I would love to see the money from this lawsuit go towards prevention and maybe also for those who are addicted to get them some help," she said.
“It’s very clear that these companies were at least willing to profit on the carnage that has taken place as a result in Arkansas,” Jerome Tapley, who is representing Arkansas on behalf of Cory Watson Attorneys, told Newsweek.
The Association of Arkansas Counties, the Arkansas Municipal League and the State of Arkansas brought the suit in the Crittenden County Circuit Court on Wednesday.
The lawsuit was filed on the heels of President Trump’s opioid plan rollout, which focused heavily on punishing drug dealers and stopping drugs from entering the US illegally. At a speech in Manchester, New Hampshire Monday the president said he was also considering bringing a lawsuit against pharmaceutical companies.
“Our Department of Justice is looking very seriously at bringing major litigation against some of these drug companies," he said. "We'll bring it at a federal level. Some states are already bringing it, but we're thinking about bringing it at a very high federal level and we'll do a job."
Shares of opioid-producing companies dropped after the speech: Endo International and Depomed shares dropped nearly 4 percent and Mallinckrodt fell 5.5 percent.
Pharmaceutical companies named in the case told Newsweek that while they deny the allegations, they recognize that opioids have been misused in the past and are taking steps to prevent that.
Healthcare Distribution Alliance, a national trade association representing wholesale distributors of opioids, told Newsweek that "[T]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."
"Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation,” the alliance said.
Last month, Attorney General Jeff Sessions said he would create a task force "to examine existing state and local government lawsuits against opioid manufacturers to determine if we can be of assistance."
But Arkansas officials are worried that the Federal government’s lawsuit won’t properly allocate money at a local level.
“We applaud the Federal government for weighing in, but recognize the brunt of this is at the local level,” said Tapley. “This is a problem for county and city personal. We welcome any help that might come from the Justice Department in the form of aid, but this is really primarily our problem."
The lawsuit asks specially for "past damages and restitution for monies spent by state, counties and city for those extraordinary and additional services provided which they would not have otherwise incurred but as a result of the Arkansas Opioid Epidemic and their past efforts to abate it." It also asks for funding for Naloxone kits, the creation of mental health and Opioid abuse treatment clinics, and overdose response teams.
"We want funding to create programs to restore Arkansas and that means drug treatment and prevention. We don't just want money that would go into the county or city treasury," said Tapley.
States like Iowa and North Carolina has expressed interest in copying Arkansas’s method into similar suits, Chris Villines, Executive Director of the Association of Arkansas Counties, told Newsweek.
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City suing defendants who would rather stay out of court
Mar 26, 2018 | Jacksonville Daily Record (FL)
By Max Marbut
The defendants named in the City of Jacksonville’s opioid lawsuit are well-versed in the litigation process, particularly when it comes to settling matters instead of appearing in court.
Jacksonville sued opioid manufacturers, pharmaceutical distribution and sales companies and former executives of the companies.
Since 2007, the defendants have agreed to plea agreements for similar opioid-related damage claims and criminal charges brought by numerous jurisdictions totaling more than $1.2 billion.
Those figures are included in the 144-page complaint for damages and injunctive relief filed in the 4th Judicial Circuit by the city against Perdue Pharma LLP and 24 other defendants.
The complaint alleges that the defendants engaged in a systematic plan to deceive doctors and patients about the products’ efficacy in the management of chronic pain and the addictive nature of their products.
Perdue leads the list with the earliest – and largest – settlement cited in the complaint.
In 2007, the company and three of its top executives were indicted in federal court in Virginia and pled guilty to fraud in promoting OxyContin as an appropriate and nonaddictive treatment for chronic pain that was less subject to abuse than other pain medications.
Under the plea agreement, Perdue agreed to pay $600 million in criminal and civil penalties. In addition, the company’s chief executive officer, general counsel and chief medical officer pled guilty and agreed to pay a total of $34.5 million in penalties.
Defendant Cephalon was charged by the U.S. Attorney in the Eastern District of Pennsylvania with selling its product, Actiq, for uses other than those approved by the Food and Drug Administration.
Actiq is a fentanyl drug in the form of a lozenge that was intended only for cancer patients who had developed a tolerance for morphine-based painkillers.
Cephalon was charged with promoting and selling the drug to doctors who were not oncologists but instead treated noncancer patients with conditions such as anticipation of changing wound dressings, injuries and migraines.
In 2008, the company agreed to pay $50 million to settle the off-label marketing charges. In a separate civil agreement, Cephalon also agreed to pay more than $375 million to resolve charges that it violated the federal Controlled Substances Act related to the off-label selling.
Endo Health Solutions Inc. and Endo Pharmaceuticals Inc. entered into a settlement in 2016 with the New York Attorney General over how the companies marketed and sold the opioid Opana ER.
The complaint alleged that the companies provided training materials to its sales representatives stating that addiction to opioids was not common and that “symptoms of withdrawal do not indicate addiction,”
As part of the settlement, Endo paid a $200,000 penalty and agreed to stop making such claims about its product and about opioids in general.
McKesson Corp., Cardinal Health Inc. and Amerisource Bergen Drug Corp., distributors of opioids, were investigated by the Drug Enforcement Administration.
The companies were found to have failed to operate in good faith mandatory internal oversight programs; failed to report suspicious orders to the DEA; and failed to halt shipment of “suspicious orders” for controlled substances.
McKesson agreed to pay a $150 million fine to the U.S. Department of Justice.
Cardinal agreed to pay a $34 million fine related to the DEA investigation as well as $20 million to settle a lawsuit based on similar charges brought by the State of West Virginia. Amerisource Bergen also agreed to pay West Virginia $16 million for settlement of the same litigation.
The city’s complaint was filed Feb. 27 by Assistant General Counsels Jon Phillips and Tiffany Douglas Safi.
Retained as outside counsel for the litigation is New York City-based Scott + Scott Attorneys at Law LLP, which is representing numerous other municipalities that have filed similar complaints against the same defendants.
Under the terms of an engagement agreement, the law firm would receive 15 percent of the net recovery if the case is settled before trial; 20 percent if the case proceeds through trial and appeal.
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Bay, P.C. opioid cases tied in to national suit
Mar 26, 2018 | Panama City News Herald (FL)
By John Henderson
Bay County’s and Panama City’s opioid lawsuit against pharmaceutical companies is now part of a massive national legal case before a judge in Ohio.
Judge Dan Aaron Polster of the Northern District of Ohio has been assigned the task of resolving more than 400 federal lawsuits brought by cities, counties and Native American tribes against central figures in the national opioid tragedy, including makers of the prescription painkillers, companies that distribute them and pharmacy chains that sell them. According to a March 6 story in the New York Times, Polster is urging of lawyers to efficiently settle the case in a way that will provide meaningful solutions to the crisis rather than focusing on a trial and “finger-pointing.”
“It is not class-action; it’s multi-district litigation,” said attorney Cliff Higby, who is one of the lawyers representing the county and city in the case. “Everybody has claims that are standing on their own.”
With 121.2 prescriptions issues per 100 people in 2016, Bay County has the second highest per capita rate of opioid prescriptions in the state, led only by neighboring Washington County. County leaders said the high number of prescriptions has resulted in the county shelling out funds for incarcerating people, medical treatment, law enforcement and other associated costs.
“All the other cities and counties are going to have similar claims to Bay County, including excess burden on the financial resources of the county due to the nuisance and the epidemic of opiote drugs,” Higby said.
Higby said the main argument is that opioid distribution companies have been negligent in the distribution of opioids.
“They are regulated by the federal controlled substance act and they have a duty to monitor the flow of opiate drugs into communities and to regions, and they have been failing in that regard,” he said.
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County plans response to opioid crisis
Mar 24, 2018 | Northeast Georgia News (GA)
By Diana Wagner
The Floyd County Commission is preparing to establish a community board to address the problems of opioid addiction.
Floyd Against Drugs may be tapped as the lead agency, Commission Chair Rhonda Wallace said, but the initiative will likely include representatives from NAMI Rome, Highland Rivers Health, the city of Rome and other governments.
"It could be regional," said County Clerk Erin Elrod, who researched what other cities and counties have done across the nation. "Someone needs to fund a coordinator to put it all together."
Rome and Floyd County joined a class action lawsuit against a dozen or so top opioid manufacturers, seeking to recoup costs of dealing with local addictions they call epidemic.
Cartersville and Chattooga and Whitfield counties also are part of the suit that Rome attorneys Andy Davis and Bob Finnell said has been accepted by a federal district court in Ohio, where claims from around the country are being consolidated. The Polk County Commission recently joined another group of municipalities in a suit filed by Cedartown law firm Parker and Lundy.
While officials are hoping for a settlement to fund local efforts, Floyd County commissioners said they don't want to wait to take aim at the problems.
"Opioids are our immediate crisis, but we should think about expanding this to all drugs," Commissioner Wright Bagby said.
The concept was seconded by Commissioner Allison Watters. She noted that experts such as Dr. Bob Williams — who headed the detoxification program at the now-closed Northwest Georgia Regional Hospital — have described their patients as "poly-addicted" to a number of different substances.
Crisis responses
Elrod presented a summary of basic practices that have met with success in other communities, beginning with a coalition ranging from health professionals, courts and police to teachers, faith leaders and employers.
"And a lot of places have some kind of drug diversion task force, trying to catch it on the streets," she said.
Examples are the city of Everett, Washington, which pairs police officers with social workers; Arlington, Massachusetts, which added a mental health clinician to its police department; and the city of Binghamton, New York, which has an "intensive care navigator" to support people leaving short-term crisis centers.
Rome and Floyd County police already have been issued and trained in the use of Narcan to combat opioid overdoses, but some other communities go farther.
"In bigger cities they have the spray at libraries and places where homeless and other at-risk people congregate," Elrod said.
Floyd County "is ahead of the game" with its drug court, she said, but some communities are trying innovative referral programs that encourage addicts to turn themselves in.
Anaheim, California, and Glouchester, Massachusetts, are two places where people can approach police, turn over their drugs and be connected to recovery resources without facing charges.
Community mobilization events, partnerships with schools, and publicizing the state prescription drug monitoring program to cut down on "doctor shopping" are among the other potential initiatives. Education on what's already in place is another.
"We have safe drug disposal sites, but a lot of people don't know about them," Elrod said.
There are 24-hour locked drop boxes at Walgreen's, 701 Martha Berry Blvd., and at the Floyd County Jail booking lobby, 2526 New Calhoun Highway, in Rome.
In nearby counties, there are boxes at the Chattooga County Sheriff's Office in Summerville, open from 8 a.m. to 5 p.m. during the week, and 24/7 at the Polk County Sheriff's Office, 1676 Rockmart Highway in Cedartown and the Bartow County Jail, 104 Zena Drive in Cartersville.
"These are all good ideas, and we'll be identifying people to work on them," Wallace said.
The lawsuits are based on marketing in recent years of opioid drugs like OxyContin and hydrocodone as safe alternatives to older painkillers such as morphine.
Nationally, the prescribing rate in 2016 was 66.5 prescriptions per 100 people, according to the Centers for Disease Control and Prevention — but some counties had rates that were seven times higher.
Floyd County’s rate was 153.3 per 100, while Chattooga’s was 131.4 and Polk’s was 166.8.
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Bainbridge, Hospital Authority join opioid lawsuit
Mar 23, 2018 | The Post Searchlight (GA)
By Carolyn Iamon
Members of Memorial Hospital and Manor Authority voted at their monthly meeting Tuesday afternoon to participate with the City of Bainbridge and Decatur County Commission in the Opioid class action lawsuit being filed by the law firm of Blasingame, Burch, Garrard & Ashley, PC. against the pharmaceutical companies that manufacture opioids. The vote was far from unanimous. There were three yeas and three nays, with Authority President Glennie Bench, breaking the tie with a yes vote.
The City of Bainbridge chose to join the lawsuit Tuesday night by a unanimous vote.
The lawsuits claim opioid usage has become an epidemic in Georgia, putting strains on healthcare, draining public resources and increasing costs on law enforcement.
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.
A thorough review of the key financial indicators for the month of February was had and Hospital CEO Jim Lambert called it “A good month.”
There was a net income of $39,524 for the month in contrast with January, 2018, when there was a loss of $223,413; and compared to February, 2017, when the loss was $258,708. Lambert’s monthly report included information on some of the following issues:
• The recent forum held for the Collaborative Impact for Decatur County, where information was shared about the results of the research conducted into the key health issues of the county and the plan developed on how to address the issues.
• An update on the evaluation for development of a wound clinic to be used in treatment of such things as diabetic issues, burns, spider bites, etc.
• A contract has been sent to a prospective new OB/GYN physician who was interviewed and expressed interest. Response needed by March 27.
• A new IT director, Michael Reynolds, has been hired. He comes from Archbold Medical Center. The search for a new CFO continues.
• The Georgia HEART campaign should be a good thing for the hospital and all taxpayers. An effort is being worked on to reach out to the whole community to encourage participation.
• The establishment of an Employee Advisory Committee to help him identify issues and concerns and work together to find solutions. The first meeting of 16 persons willing to serve was scheduled for Thursday, March 22.
The construction projects are continuing at the hospital and several issues were discussed as the Authority reviewed the Building and Grounds Committee meeting minutes. The front entry has been blocked off to accommodate the work going on in that area, including the replacement of flooring and the automatic doors.
A planning retreat for board members has been scheduled for April 20 and 21, and Lambert indicated there would be a presentation from the Georgia Hospital Association to assist with planning procedures.
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ATTORNEY FILES FEDERAL LAWSUIT AGAINST DRUG MAKERS
Mar 23, 2018 | WDEF (TN)
By Collins Parker
Governmental agencies at the federal and state level are launching dozens of programs to deal with the opioid crisis in this country.
A Chattanooga attorney is filing a civil lawsuit in federal court against the manufacturers and distributors of opioids.
Ronnie Berke says “Almost every part of Hamilton County government is going to have some cost due to the opioid crisis.”
Attorney Ronnie Berke says a lawsuit will be filed in Federal Court within a week—a separate action from what is being pursued by district attorneys around the state.
He says their proposed action against manufacturers and distributors will be limited.
The local district attorney’s office is not part of that effort.
Berke says “Part of the reason we’re bringing this suit is not only to get Hamilton County reimbursed, because the taxpayers are subsidizing the side effects of these pills, not only to get the county reimbursed but we would like to see some rehab programs, set up so that we can get people off these drugs.”
Berke says that in Hamilton County in 2016 there were way more than a thousand prescriptions written for every 1,000 people.
There were 942 overdoses in 2015, and 59 deaths.
Many of those deaths are from illegal manufacturers…but that’s part of the overall opioid crisis.
Tommy Farmer “there’s still the large pink elephant in the corner. It’s still diverted, prescribe opioids. That’s still the number one killer. When we’re seeing those numbers decrease and they are going down significantly in terms of the amount of opioids being prescribed or diverted in our state doctor shopping numbers have fallen significantly.”
Berke “All of this was created by the drug industry intentionally. They were telling doctors at the beginning not only with our drug reps, but even with their ads in medical journals, that opioids were not addictive.”
Berke says what he’s doing is not a class action suit, but one designed to repay for untruthfulness by the pharmaceutical industry.
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Pasquotank may join opioid lawsuit
Mar 24, 2018 | Daily Advance (NC)
By Jon Hawley
Pasquotank County officials are considering joining national litigation against opioid manufacturers and distributors — litigation that if successful could help Pasquotank defray its costs responding to the crisis that addiction to the drugs is causing.
Winston-Salem-based attorney Garry Whitaker asked Pasquotank to join the litigation during county commissioners' finance committee meeting earlier this week.
Whitaker explained he works with a national consortium of law firms seeking major damages from opioid manufacturers and distributors. Twenty-five counties and five cities in North Carolina have hired the consortium, including Pitt County and the cities of Wilmington and Fayetteville, he said.
Whitaker said local governments across the country are acting under “multi-district litigation” against the drug companies, including distributors such as McKesson, Cardinal Health and AmeriSource Bergen, to claim damages on numerous grounds. The litigation started in West Virginia — Whitaker described it as “ground zero” for opioid abuse — after counties there were dissatisfied with a state settlement.
The litigation has now grown to include six major law firms, including Baron and Budd, of Texas, and Levin Papantonio, of Florida, Whitaker said. Those two firms alone have “$15 billion in experience in both settlements and verdicts,” he said.
“This is a very strong consortium of attorneys; they will not stop until they have gotten some results in these cases,” he said.
Whitaker said Pasquotank should join the litigation because opioids have proliferated in the county and caused damages.
Citing federal statistics, Whitaker noted that Pasquotank’s prescription rate for opioids grew to about 131 prescriptions per 100 residents in 2015, or almost double the national average. That means numerous county residents have multiple prescriptions.
Whitaker also reported those prescriptions are often for a month to two months. New medical guidelines suggest that opioids should be prescribed only for short-term, acute pain to minimize risk of addiction.
Whitaker said opioid distributors, under the Controlled Substances Act, are required to report “suspicious orders” that reflect changes in volume or frequency of orders. Noting that McKesson, Cardinal Health and AmeriSourceBergen have achieved 85 percent market share in opioid distribution, he said they had to have not reported suspicious orders to do so. McKesson and Cardinal Health have recently paid multi-million-dollar fines for reporting failures, he added.
Whitaker also argued that the rise in opioid prescriptions has increased opioid deaths in Pasquotank. Seven county residents died from opioid poisoning in 2016, according to his data.
“Where the death rate goes up, the prescription rate goes up; you don't get there without suspicious orders,” he claimed.
In addition to allegedly not reporting suspicious orders for opioids, Whitaker also claims manufacturers and suppliers misled medical professionals and the public about the drugs.
“They oversold the benefits and undersold the risks,” he said. “The doctors are not to blame. … Our case is not against doctors, and it's not against pharmacists.”
In inviting Pasquotank to join the litigation, Whitaker said the county stands to receive a share of whatever damages the attorneys ultimately win. Asked later how long the case would likely take, he said he didn't know.
Whitaker also said Pasquotank would not have to pay the consortium for its services. The law firms involved would take 25 percent of the amount recovered from the companies, he said, with counties able to use the remainder to combat opioids.
Commissioner Lloyd Griffin asked if there was any risk that North Carolina Attorney General Josh Stein would pre-empt the local governments' lawsuits, meaning the state would take over the litigation.
“I am not convinced our state AG actually has preemption power,” Whitaker said.
Regardless, he said Stein has expressed no interest in pre-empting the consortium, nor has he discouraged its work.
“What he has said is, all of us have a role to play, and if anything, I think these local government actions are actually helping the (state attorneys general),” Whitaker said.
Counties have different damages to claim than states do, he added, citing increased costs to ambulance services, social services and other entities responding to opioid abuse.
Commissioners agreed to consider Whitaker's offer, and directed County Attorney Mike Cox to study the litigation further.
In an interview Friday, Cox said he plans to review the litigation in detail next week. However, he said there is “slim risk” of Pasquotank being held liable for a portion of drug companies' legal costs if a judge ruled against local governments. Such a ruling would require finding the claims against the companies were without merit, a high bar to meet, he explained.
Winston-Salem-based attorney Garry Whitaker asked Pasquotank to join the litigation during county commissioners' finance committee meeting earlier this week.
Whitaker explained he works with a national consortium of law firms seeking major damages from opioid manufacturers and distributors. Twenty-five counties and five cities in North Carolina have hired the consortium, including Pitt County and the cities of Wilmington and Fayetteville, he said.
Whitaker said local governments across the country are acting under “multi-district litigation” against the drug companies, including distributors such as McKesson, Cardinal Health and AmeriSource Bergen, to claim damages on numerous grounds. The litigation started in West Virginia — Whitaker described it as “ground zero” for opioid abuse — after counties there were dissatisfied with a state settlement.
The litigation has now grown to include six major law firms, including Baron and Budd, of Texas, and Levin Papantonio, of Florida, Whitaker said. Those two firms alone have “$15 billion in experience in both settlements and verdicts,” he said.
“This is a very strong consortium of attorneys; they will not stop until they have gotten some results in these cases,” he said.
Whitaker said Pasquotank should join the litigation because opioids have proliferated in the county and caused damages.
Citing federal statistics, Whitaker noted that Pasquotank’s prescription rate for opioids grew to about 131 prescriptions per 100 residents in 2015, or almost double the national average. That means numerous county residents have multiple prescriptions.
Whitaker also reported those prescriptions are often for a month to two months. New medical guidelines suggest that opioids should be prescribed only for short-term, acute pain to minimize risk of addiction.
Whitaker said opioid distributors, under the Controlled Substances Act, are required to report “suspicious orders” that reflect changes in volume or frequency of orders. Noting that McKesson, Cardinal Health and AmeriSourceBergen have achieved 85 percent market share in opioid distribution, he said they had to have not reported suspicious orders to do so. McKesson and Cardinal Health have recently paid multi-million-dollar fines for reporting failures, he added.
Whitaker also argued that the rise in opioid prescriptions has increased opioid deaths in Pasquotank. Seven county residents died from opioid poisoning in 2016, according to his data.
“Where the death rate goes up, the prescription rate goes up; you don't get there without suspicious orders,” he claimed.
In addition to allegedly not reporting suspicious orders for opioids, Whitaker also claims manufacturers and suppliers misled medical professionals and the public about the drugs.
“They oversold the benefits and undersold the risks,” he said. “The doctors are not to blame. … Our case is not against doctors, and it's not against pharmacists.”
In inviting Pasquotank to join the litigation, Whitaker said the county stands to receive a share of whatever damages the attorneys ultimately win. Asked later how long the case would likely take, he said he didn't know.
Whitaker also said Pasquotank would not have to pay the consortium for its services. The law firms involved would take 25 percent of the amount recovered from the companies, he said, with counties able to use the remainder to combat opioids.
Commissioner Lloyd Griffin asked if there was any risk that North Carolina Attorney General Josh Stein would pre-empt the local governments' lawsuits, meaning the state would take over the litigation.
“I am not convinced our state AG actually has preemption power,” Whitaker said.
Regardless, he said Stein has expressed no interest in pre-empting the consortium, nor has he discouraged its work.
“What he has said is, all of us have a role to play, and if anything, I think these local government actions are actually helping the (state attorneys general),” Whitaker said.
Counties have different damages to claim than states do, he added, citing increased costs to ambulance services, social services and other entities responding to opioid abuse.
Commissioners agreed to consider Whitaker's offer, and directed County Attorney Mike Cox to study the litigation further.
In an interview Friday, Cox said he plans to review the litigation in detail next week. However, he said there is “slim risk” of Pasquotank being held liable for a portion of drug companies' legal costs if a judge ruled against local governments. Such a ruling would require finding the claims against the companies were without merit, a high bar to meet, he explained.
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Two municipalities sue over opioid crisis
Mar 26, 2018 | Virginia Lawyers Weekly (VA)
By Matthew Chaney
Two Virginia localities are suing more than 30 pharmaceutical companies they say are responsible for opioid epidemics in their communities. The City of Alexandria and Dickenson County filed lawsuits against manufacturers, distributors and pharmacy benefit managers March 14. The local governments claim they are suing to recoup financial losses from “the public health emergency caused by prescription.
The remainder of this article is under paywall: https://valawyersweekly.com/2018/03/26/two-municipalities-sue-over-opioid-crisis/
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Mashpee Considers Joining Pharmaceutical Opioid Lawsuit
Mar 23, 2018 | The Mashpee Enterprise (MA)
By Sam Houghton
The Mashpee Board of Selectmen has considered joining a lawsuit filed by hundreds of towns and cities across the country looking to recoup financial losses caused by the opioid epidemic.
Thomas T. Merrigan, an attorney with Sweeney Merrigan Law, recently approached Mashpee asking if the town would join the legal battle to hold large pharmaceutical manufacturing and wholesale companies accountable for what has happened.
The firm represents the City of Greenfield, the first municipality in Massachusetts to file in the rare legal case. The city filed the lawsuit in the US District Court in Massachusetts in December.
The lawsuit has gained considerable momentum. About 70 municipalities in the commonwealth have joined including Sandwich on the Upper Cape, according to the firm.
The complaint filed by the firm alleges that some 20 pharmaceutical companies “aggressively pushed highly addictive, dangerous opioids, falsely representing to doctors that patients would only rarely succumb to drug addiction.” The complaint was filed in December.
“These pharmaceutical companies ... turned patients into drug addicts for their own corporate profit,” the filing states.
The lawsuit aims to recoup costs associated with the epidemic, including, among other things, medical treatment for ailments including overdoses and deaths, interventions, assistance to babies born with addiction, law enforcement, several forms of care, and a number of other issues associated with the “crisis” created by the companies.
Mr. Merrigan is confident that the lawsuit, called multidistrict litigation rather than class action, will eventually reach a settlement in which defendants and plaintiffs come up with a formula to pay back communities listed in the lawsuit. Municipalities unsatisfied with the formula could go to trial, Mr. Merrigan noted.
While the cost of the epidemic on Mashpee’s bottom line is hard to estimate, as an indication, the Mashpee Police Department reported that officers responded to 40 cases of opioid overdose and one opioid-related death last year. The number is probably higher as Mashpee Fire Rescue likely responded to other overdoses as well.
Selectmen and town officials in Mashpee declined to discuss the lawsuit recently, but the board met in executive session on Monday, March 12, with an agenda item noting the litigation. The issue will likely come up for a discussion in public on a future selectmen’s agenda, according to town officials.
Mr. Merrigan, a Falmouth resident, said that his firm now represents close to 75 cities and towns across the commonwealth including Provincetown, Nantucket, Truro, Sandwich and Brewster. The firm also is in discussion with several other Cape towns, including Falmouth.
In the lawsuit, the plaintiffs list Purdue Pharma, Johnson & Johnson, Teva Pharmaceuticals, Cardinal Health and several other pharmaeceutical companies. The lawsuit also targets wholesale distributors for intentionally and or unlawfully breaching duties to “monitor, detect, investigate, refuse and report suspicious orders of prescription opiates.”
Judge Dan Aaron Polster, a judge in Cleveland, Ohio, has overseen the larger lawsuit, and, according to the New York Times, is aggressively pushing for the two sides to come to a settlement. A story in the paper in early March indicated that some 400 municipalities had entered the case.
Mr. Merrigan said that there is no reason why a town like Mashpee would not want to join. Sweeney Merrigan Law would represent the town on a contingency basis. And ultimately, if the case is settled, funds would go directly to the coffers of the local municipalities, Mr. Merrigan said. “This will be to their benefit,” Mr. Merrigan said. “There’s a lot to be gained and nothing to be lost.”
Mr. Merrigan said that the theory behind the case is that most, if not all, of the Massachusetts’ communities have had ongoing expenses related to the epidemic, whether through law enforcement or elsewhere. A town, for example, might hire a special school resource officer to help. “There’s an actual expense dealing with this situation,” Mr. Merrigan said.
The lawsuit could come up with an actual number to fix the nuisance. “What kind of resources does Mashpee need, what kind of education and social services will they need into the future to unravel and unwind the effects of this epidemic?”
“I think the liability is extraordinary,” he said. Opioid manufacturers should have reported suspicious misuse of prescriptions for years, but instead, the attorney said, they spent billions of dollars pushing opioids with misinformation campaigns, even targeting easily addicted communities.
“This is not like cigarette smoking where there’s a choice,” Mr. Merrigan said. “This has been a greedy, misleading, deceptive kind of medicine and it is costing billions of billions of dollars as well as phenomenal human loss.”
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Morrisville agrees to sue opioid companies
Mar 23, 2018 | The Intelligencer (PA)
By Thomas Friestad
Morrisville is entering a nationwide legal fray against major pharmaceutical companies.
By a unanimous vote, council members decided to work with Philadelphia firm Feldman & Pinto to evaluate how the opioid crisis has affected and will continue to affect Morrisville.
The borough then could sue for the money it spent on emergency services, drug awareness and disposal programs, as one of the hundreds of governments now participating in multi-district litigation over alleged improper opioid diversion and marketing.
If Morrisville wins in court, Feldman & Pinto will receive 20 percent of any damages the borough is awarded.
Before council members’ vote, several residents spoke up in favor of the motion.
Resident Hal Wilcox told council members, “I’m telling you, if you don’t OK to be a part of this lawsuit and go after the pharmaceutical companies, we’re never going to kill this epidemic.”
“You’ve gotta be a part of this.”
The Healthcare Distribution Alliance, a national trade association representing opioid distributors, emailed this news organization a statement from John Parker, its senior vice president, following a previous story about Morrisville’s prospective lawsuit.
“The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders,” Parker said. “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. Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”
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El Paso County asked to join opioid lawsuit against pharmaceutical giants
Mar 24, 2018 | The Gazette (CO)
By Rachel Riley
El Paso County has been asked to join hundreds of cities and counties that are suing major pharmaceutical companies, blaming them for exacerbating a nationwide epidemic of opioid abuse and overdoses and demanding compensation for the costs.
The proposition has left county officials with the difficult task of calculating the exact amount of taxpayer dollars that have been lost to the opioid crisis through social services, law enforcement activities and other government functions.
In late January, Huerfano County became the first and only Colorado county to file a lawsuit against big-name drug manufacturers and distributors, said Stephen Ochs, one of the lawyers representing that county and local governments in other states that have filed similar claims.
In a complaint filed in U.S. District Court in Denver, the small southeastern county accused defendants - including McKesson Corp., Janssen Pharmaceuticals of Johnson & Johnson and Purdue Pharma - of using deceptive advertising and marketing strategies to overstate the benefits of opioids and understate the risk of addiction. The lawsuit claims "past economic damages exceeding $750,000" and estimates future damages of more than $1.5 million, citing money the government spent on "police, fire, medical and other public services."
Ochs, who said his Colorado Springs-based firm has approached nearly half of the state's 64 counties about filing their own complaints, is one of several attorneys that have reached out to the county offering representation in the opioid litigation.
But the county is far from deciding whether or not it will become a part of the movement, said county spokesman Dave Rose.
"What we're looking at now is, does the county have any damages associated with this?" said El Paso County Commissioner Mark Waller.
Waller said he's yet to see any convincing evidence that there is.
In an executive session Thursday, the county coroner and the Department of Human Services presented to commissioners the data they had related to opioids, Rose said.
The coroner reported that 10 percent of deaths from 2012 to 2016 have "links to opioids," Rose said in an email. Last year, 77 deaths were connected to the drugs, Rose said.
In 2016, the Department of Human Services reported that 12 infants had been exposed to opioids. But aside from that information, the department has little else to offer on the topic, Rose said. There's no way of knowing if those who apply for economic assistance, such as food stamps, are using the drugs, he said.
Commissioners have directed the county attorney's staff to request data from the District Attorney's Office and the Sheriff's Office, Rose said.
A report released last month by the Community Health Partnership, a coalition of organizations dedicated to improving the community's well-being, found that opiates contributed to the deaths of 120 people in El Paso County in 2016. The organization's CEO, Aimee Cox, told The Gazette that more than 30 million opioid pills were dispensed in El Paso County in 2016, equaling 767 prescriptions per 1,000 residents. With that came increased first responder, emergency room and substance abuse treatment costs, she said.
Colorado Attorney General Cynthia Coffman is working as part of a bipartisan coalition of dozens of other state attorneys general to investigate pharmaceutical companies' role in the epidemic. In September, the coalition served investigative subpoenas to several companies, asking for information about their business practices, Coffman's office said in a press release. State attorneys general, including those in hard-hit Ohio and Kentucky, have filed lawsuits against drug manufacturers and distributors, according to media reports.
Janssen Pharmaceuticals spokeswoman Jessica Castles Smith called the allegations "baseless and unsubstantiated" in a statement.
"Our actions in the marketing and promotion of these medicines were appropriate and responsible," she said, adding that the labels on the company's opioid pain medicines include information about risks and benefits.
Nationwide, more than 400 governments - represented by different legal teams - have filed complaints similar to Huerfano County's lawsuit in federal courts. Through a process known as multidistrict litigation, those lawsuits are being consolidated and transferred to a U.S. District Court in Cleveland, where a single judge will preside over them all, Ochs said.
The Healthcare Distribution Alliance, a national trade association representing wholesale distributors including McKesson, denies the companies aggravated the crisis.
"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," the association's senior vice president, John Parker, said in a statement. "Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation."
Distributors report all opioid orders to the Drug Enforcement Administration, which sets annual production rates for controlled substances and regulates the entities that handle and prescribe the drugs, according to the association.
Ochs estimates that the crisis is costing El Paso County "millions of dollars a year."
Governments commonly spend money to meet a variety of citizen needs related to the opioid crisis, including housing inmates who are crowding local jails, providing guardian services to children whose parents suffer from addiction and equipping first responders with life-saving opioid antidotes for those overdosing on the drugs.
Those prescribed the drugs initially for pain management can become addicted and, when their prescriptions run out or they can no longer afford to buy drugs like OxyContin on the streets, they often resort to using heroin, Ochs said.
"What has happened is these pharmacy companies make a tremendous ... profit on the addiction of the citizens of our community. The only way to stop this is to hold them accountable financially," said Colorado Springs attorney Pat Mika, who's working with Ochs to represent local governments in the opioid cases. "Our goal is to do everything we can to hit them where they feel it so that we will stop the advertisements, we will stop the unfettered distribution of these drugs, and that they will change their practices."
Ochs said that, for jurisdictions represented by his team, there are no risks. Those governments won't have to pay them unless there's a verdict or judgment in the plaintiff's favor. And, if the judge sides with the pharmaceutical companies, the attorneys will cover any resulting costs or expenses for their clients, Ochs said.
While there's no deadline for the county to file it's complaint, Ochs and Mika said the sooner the county files, the better its chances are to recover some of its losses. "There is no downside. All there is an upside. If we win, they win. If we lose, they don't have to pay any of the costs associated with this," Mika said. "We don't want El Paso County - or any other county that we have spoken with - to be left behind."
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Utah’s attorney general says a lawsuit over opioids is drafted, but he’s not filing it yet
Mar 26, 2018 | Fox 13 (UT)
By Ben Winslow
Utah Attorney General Sean Reyes has drafted a lawsuit against "Big Pharma" over the opioid crisis.
He's a few weeks away from taking bids for outside counsel to litigate it.
But the attorney general told FOX 13 in an interview Friday he wants to keep negotiating alongside 43 other states with pharmaceutical companies in hopes of reaching a settlement without having to file a lawsuit.
"We may get a settlement that Utah finds acceptable. Then, we've also saved legal fees having to pay out on a contingency or any other arrangment," Reyes said. "But I want no Utahn to doubt that if we can't get what we want from a settlement -- we will have no hesitation to file a lawsuit."
He's a few weeks away from taking bids for outside counsel to litigate it.
But the attorney general told FOX 13 in an interview Friday he wants to keep negotiating alongside 43 other states with pharmaceutical companies in hopes of reaching a settlement without having to file a lawsuit.
"We may get a settlement that Utah finds acceptable. Then, we've also saved legal fees having to pay out on a contingency or any other arrangment," Reyes said. "But I want no Utahn to doubt that if we can't get what we want from a settlement -- we will have no hesitation to file a lawsuit."
Reyes has faced increased pressure to sue over the opioid crisis, where companies are accused of over-marketing and pushing pills that have led to addiction problems plaguing states. Almost one person a day dies in Utah from an opioid-related cause.
The Utah State Legislature passed a resolution this year, calling on the attorney general to file a lawsuit. House Speaker Greg Hughes, R-Draper, has been critical of the attorney general's speed in pursuing litigation.
"I get that they want to see action," Reyes said Friday. "It's my job to make sure we're expending resources properly, we're approaching a case in the best possible way to put us in a position to win."
The attorney general said he favors teaming up with other states, sharing information and resources. Reyes pledged that if settlement talks broke down, he would pursue a lawsuit like the Utah State Legislature has demanded.
Some believe Reyes is not moving fast enough. Earlier this week, Summit County filed its own lawsuit over the opioid problem. Salt Lake and Utah counties have also planned lawsuits.
The addiction problems exposed as a result of "Operation Rio Grande," the crackdown on crime surrounding the downtown homeless shelters, has led to a renewed push for litigation. Similar to lawsuits against "Big Tobacco," money from an opioid lawsuit would be used to pay for substance abuse treatment, jails, and other services.
Reyes said he believed that this approach would yield better results, pointing out that other states who have preferred to sue by themselves have found judges have stalled the lawsuits while multi-state litigation proceeds.
"All of the 43 states that are a part of it? We have a lawsuit ready to go and we would come down aggressively if we felt like they were negotiating in bad faith and negotiations break down and we can't come to a settlement," Reyes said.
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Geauga County files lawsuit to help fight opioid epidemic
Mar 23, 2018 | The News-Herald (OH)
By Tracey Read
Geauga County has officially filed a federal lawsuit against opioid manufacturers and distributors to help offset a dramatic increase in costs for law enforcement, addiction treatment and overdose prevention because of the drug epidemic.
Geauga County has officially filed a federal lawsuit against opioid manufacturers and distributors to help offset a dramatic increase in costs for law enforcement, addiction treatment and overdose prevention because of the drug epidemic.
Last month, county commissioners voted to file the suit, which alleges pharmaceutical companies did not follow federal rules over the escalating use of opioids by Ohio residents.
The 167-page lawsuit was filed recently in U.S. District Court by Cleveland-based Spangenberg, Shibley & Liber. Lawyers will work for the county on a contingency basis, meaning a fee — calculated as a percentage of any money awarded — will be charged only if the suit is successful.
The suit is seeking unspecified damages from 17 companies, including Purdue Pharma, Cardinal Health and AmerisourceBergen Corp. for alleged public nuisance, racketeering, negligence, negligent representation, fraud and violations of the Ohio Corrupt Practices Act.
“The opioid epidemic is particularly devastating in (Geauga County),” attorneys Peter Weinberger and William Hawal said in the lawsuit. “(Geauga County) is experiencing an excessive drug overdose rate related to an excessive volume of prescription opiates caused by the wrongful conduct by the defendants...”
According to the suit:
• The defendants intentionally manufactured, marketed and sold prescription opioids without maintaining effective controls to monitor, report and stop shipment of suspicious orders.
• The defendants’ actions created and expanded the use of dangerously addictive opioids, causing the current epidemic of prescription opioid and heroin addiction.
• The manufacturers and distributors schemed to make billions in illegal sales of opioids.
• The defendants paid nearly $800 million to influence local, state and federal governments through joint lobbying efforts as part of the Pain Care Forum. The lobbying efforts included initiatives to pass laws making it more difficult for the Drug Enforcement Administration to suspend and/or revoke the companies’ registrations for failure to report suspicious opioid orders.
The case has been assigned to Judge Dan Aaron Polster in Cleveland.
Similar suits have been filed across the nation and in nearby counties, including Cuyahoga, Lake and Ashtabula.
However, officials with the Healthcare Distribution Alliance, representing distributors including McKesson, Cardinal Health and AmerisourceBergen, claim the allegations in such suits are unfair.
“As distributors, we understand the tragic impact the opioid epidemic has on communities across the country,” John Parker, senior vice president of Healthcare Distribution Alliance, previously told The News-Herald. “We are deeply engaged in the issue and are taking our own steps to be part of the solution — but we aren’t willing to be scapegoats.
“Distributors are logistics companies that arrange for the sale and secure storage, transport and delivery of medicines from manufacturers to pharmacies, hospitals, long-term care facilities, and others based on prescriptions from licensed physicians. We don’t make medicines, market medicines, prescribe medicines or dispense them to consumers. Given our role, the idea that distributors are solely responsible for the number of opioid prescriptions written defies common sense and lacks understanding of how the pharmaceutical supply chain actually works and how it is regulated.”
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South Bend files lawsuit against opioid companies
Mar 23, 2018 | South Bend Tribune (IN)
By Lincoln Wright
The City of South Bend officially filed its federal lawsuit against the manufacturers and distributors of prescription opioids, arguing the companies played a role in the city's drug epidemic.
South Bend Mayor Pete Buttigieg briefly touched on seeking legal action in his March 12 state of the city speech. The roughly 156-page lawsuit was filed in Norther Indiana District of the United States Court on Thursday.
The city is working with law firm Taft Stettinius & Hollister LLP out of Indianapolis. The lawsuit names more than 20 companies, claiming the businesses were negligent and used corrupt business practices to mislead doctors and the public about the high risk of addiction to opioids.
Marshall and LaPorte counties also filed lawsuits in federal court and St. Joseph County has also announced plans to file its own suit. Similar lawsuits are not only increasing across Indiana, but around the U.S.
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City Weighs Costs, Benefits of Going After Big Pharma
Mar 26, 2018 | Rivard Report (TX)
By Roseanna Garza
As the City of San Antonio considers whether to join a class action lawsuit against opioid manufacturers and distributors for their alleged role in a crisis that has been devastating locally, City officials must weigh the benefits and the costs of what can become lengthy, and costly, legal action.
Pharmaceutical company representatives say placing the blame on any single entity misses the complexity of such cases. But a lawyer who has represented individuals and localities in similar lawsuits says the City itself may even underestimate current (and future) costs associated with opioid addiction and abuse.
Bob Hilliard, a double-board-certified, personal injury trial lawyer in Texas who was lead council and signed settlements with Toyota, General Motors, Coca Cola, and other large corporations, said that while the City, which does not operate jails or hospitals, may appear to have less of a stake in the lawsuit compared to the County, “there are still costs associated with addiction, abuse, and overdose” that the City incurs, including a “significant burden on the budgets of local governments.
“It is necessary to consider the number of individuals in [San Antonio] that are victim to opioid abuse and the marketing mechanisms of the manufacturers within your city,” Hilliard said.
Last October, Bexar County commissioners voted to sue opioid manufacturers and distributors, aiming to recoup the enormous costs the County incurred. That expense includes caring for, treating, and sometimes burying the addicted; supporting their children, who may become involved with Child Protective Services and welfare systems; and paying first responders and city officials who deal with overdoses and more.
District Attorney Nico LaHood chose two San Antonio firms to represent Bexar County in the county’s lawsuit: Phipps Anderson Deacon and Watts Guerra.
The City is considering whether to join the County in suing opioid drug manufacturers and distributors. The city attorney’s office is currently reviewing proposals from area law firms to determine whether it would be financially and legally sound to file a suit.
City Council has had several discussions regarding the opioid crisis and options to sue. San Antonio’s Opioid Task Force, which met for the first time Aug. 8, 2017, is a City/County collaboration to reduce the number of drug overdose deaths in Bexar County. The bimonthly meetings have provided a platform for relevant organizations and officials in the City and County to discuss the lawsuits, best practices, and create a collaborative plan to combat the issue locally.
Councilman Manny Pelaez (D8) said in a conversation with the Rivard Report on Saturday that council members are “curious” about the lawsuits coming out of other cities and counties against opioid manufacturers and distributors, and that “the general consensus is that [City Council] would rather get it right,” even if it means taking more time.
“I am not adverse to joining this litigation,” Pelaez said. “What I have been cautioning is that we need to have [our] eyes wide open walking into it.”
Across the U.S., states, counties, and municipalities are filing suits over the opioid epidemic, aiming to hold makers, wholesalers, distributors, and marketers accountable for their alleged role in the crisis that the U.S. Centers for Disease Control and Prevention reports took more than 42,000 American lives in 2016 alone.
The lawsuits have taken different approaches: Some accuse manufacturing companies of misleading healthcare professionals and the public via deceptive marketing tactics in an attempt to increase sales of opioids while failing to properly warn about the risks for addiction; some blame the wholesaler or distributor; and some suits even name the clinics that provided the pills.
While some suits have been settled, pharmaceutical companies and healthcare organizations continue to deny any claims of wrongdoing and say they are committed to helping solve the opioid epidemic.
In an email to the Rivard Report, John Parker, senior vice president of the Healthcare Distribution Alliance, a national organization representing primary pharmaceutical distributors involved in current lawsuits, said that pinpointing blame does not take into consideration how complex these cases are.
“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,” Parker said. “Those bringing lawsuits would be better served addressing the root causes, rather than trying to redirect blame through litigation.”
Parker noted that distributors are “logistics experts,” and do not manufacture, prescribe, dispense, or drive demand for opioids, and they cannot make medical determinations about patient care or provider prescribing. Distributors report every opioid order to the Drug Enforcement Agency, which is responsible for setting the annual production of controlled substances in the market.
“The misuse and abuse of prescription opioids is a complex public health challenge that requires a collaborative and systemic response that engages all stakeholders,” Parker said.
Most cities that file or join lawsuits against opioid manufacturers do so by hiring outside counsel, as opposed to handling them through their staff attorneys, Hilliard said. He explained that the benefits of using outside litigation include access to lawyers who may have “more experience and more expertise in complex litigation,” and that city attorneys “are often already overworked and overtaxed.”
Pelaez said that “securing competent council” would be the City’s most important step if it decided to move forward with a lawsuit. This means working with a lawyer who has had success in mass tort litigation for municipalities against pharmaceutical manufacturers, he said.
Bexar County leads the state in babies born with drug withdrawal symptoms and has the third-highest per-capita rate of overdose deaths in Texas, with 108 fatal overdoses in 2015.
“We very much have real damages,” Pelaez said Saturday.
However, San Antonio and Bexar County have opioid prescribing ratesthat consistently rank below the state and national averages since 2006. And while Bexar County has the third-highest per capita rate of overdose in Texas, the state has remained among those with the lowest rates of overdose deaths, despite a “statistically significant increase” from 2015-16.
Hilliard said that “any potential settlement will be proportionate based on expert reports from economists [regarding] the impact of each affected area.”
The lawsuits bear many resemblances to the litigation against Big Tobacco, which ended with a $246 billion settlement in 1998, in what is still the largest civil litigation settlement in U.S. history, and resulted in policy change, Hilliard said. He noted that when comparing opioid and tobacco litigation, “there are more similarities than there are differences.”
“A difference might be the prescription nature of the drugs at issue,” Hilliard said. “But they’re marketing to doctors who then turn around and relay that information to their patients. It may be once-removed, but it is still happening.”
He said that pharmaceutical companies will argue that doctors have the knowledge and expertise to decide, based on their best medical opinion, that someone needs an opioid prescription, which does not account for the non-prescribed or illegally made opioids that are available on the streets.
A single lawsuit against an opioid manufacturer or distributor could take anywhere from two to six years, depending on whether a settlement occurs early in the process. Hilliard said that throughout Texas, lawsuits made by cities and counties will “likely get transferred into the opioid [multi-district litigation],” where large numbers of similar cases are consolidated to enhance efficiency and reduce cost.
This would cut the settlement time frame down, with decisions made within 16 months.
“If [San Antonio] doesn’t bring a claim at all, [it] won’t be entitled to the recovery that is likely to result,” Hilliard said.
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Mar 26, 2018 | Washington, D.C.
By WDVM (WDVM)
Video Link: http://app.criticalmention.com/app/#clip/view/33835956?token=dacd3025-e9e0-48bc-91c5-e6af825ef148
Rough Transcript: trump said today (friday) that his administration will take some opioid makers to court. andy rose has more << president trump took his plan to fight the opioid epidemic a step further -- announcing on friday that his administration plans to take legal action against opioid manufacturerspresident donald trump: "we'l be suing certain drug companies for what they've done with the opioids and we'll be bringing the suits at a federal level." earlier in the week, the president laid out how he plans to spend the six billion dollars appropriated by congress to fight the opioid cris. the plan will provide help for people fighting addiction, support for local law enforcement, as well as federal funding for treatment programs and research president donald trump: "we'r looking for a medicine that can stop the pain without the addiction so that people aren't going to become addicted to these incredible drugs" the administration has its sights set on prevention. advertising campaign focused on keeping people off opioids altogether. president donald trump: "th level of drugs that are being put out there and the power of this addiction is hard to believe. people go to the hospital for a period of a week and they come out and they're drug addicts." several states and cities have taken legal action against opioid manufacturers. but president trump's announcement looks to create a federal standard.
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Mar 26, 2018 | Boston, MA
By WFXT (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33835978?token=dacd3025-e9e0-48bc-91c5-e6af825ef148
Rough Transcript: president trump's plan to compat -- combat the opioid crisis is taking shape. >> and vail the plan that supports the death penalty for drug dealers. 1:23 AMthe president says his administration will take some opioid makers to court.:the president trump took his plantae fight the opioid epidemic a step further. he announced friday that his administration plans to take legal action against opioid manufacturers. >> we will sue certain drug companies for what they have done with the opioids. we will bring the suits at a federal level. >>> the president was in new hampshire where he laid out how he plans to spend the $6 billion appropriated by congress to fight in the opioid crisis. it will provide help for people fighting addiction, support for local law-enforcement, as well as federal funding for treatment programs and research. >> we are looking for a medicine that can stop the pain without the addiction. that way people are not going to become addicted to these incredible drugs. >> reporter: the administrative administration has her sights set on prevention. they call for an advertising campaign focused on keeping people off of opioids altogether.>> the level of drugs that are being put out there, and the power of this addiction is hard to believe. people go to the hospital for a period of one week, and they come out of their drug addicts. >> reporter: several states and cities have taken legal action against it does make opioid manufacturers. the president's announcement looks to create a federal standard. >>> while the president was in new hampshire, he said the department of justice has already been working with some states were brought lawsuits forward. the president is not named any of the companies that the government is considering suing.
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Mar 25, 2018 | Springfield, MO
By KOZL (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33835967?token=dacd3025-e9e0-48bc-91c5-e6af825ef148
Rough Transcript: the association of arkansas counties says the state's unified approach in taking legal action against pharmaceutical companies is unique in this country. they're suing 65 drug makers and individuals. leaders say much of their concern stems from the fact that this epidemic is affecting people of all ages. arkansas ranks second in the nation for misuse of opioids among kids ages 12 to 17.
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