Preview Newsletter
Opioid Litigation Daily Media Report - 3/28/18
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Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.
Mar 28, 2018 | New York Times
By Jan Hoffman
Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers. -
Litigation Plays an Important Role in Addressing the Opioid Crisis, Gluck Says In Coif Speech
Mar 27, 2018 | Georgia State University
By Stacey Evans
Just as there are multiple causes that led to the opioid crisis, there are multiple intersections of response needed to address it, said Abbe R. Gluck, professor of law and the faculty director of the Solomon Center for Health Law and Policy at Yale Law School at Georgia State Law’s Order of the Coif Distinguished Visitor Lecture on March 27. -
Alexander: Draft Legislation Would Require Dispensing Opioids in Short-Term Blister Packs, Help FDA Stop Illegal Fentanyl at Borders (Press Release)
Mar 26, 2018 | U.S. Senate Committee on Health, Education, Labor and Pensions
By Sen. Lamar Alexander (R-TN)
Senate health committee Chairman Lamar Alexander (R-Tenn.) today released two discussion drafts of legislation to improve the Food and Drug Administration’s (FDA) ability to address the opioid crisis. -
McCaskill Report Finds Drug Prices Outpace Inflation
Mar 27, 2018 | St. Louis Patch (MO)
By J. Ryne Danielson
A new report by Missouri Democratic Sen. Claire McCaskill released March 26 indicates the cost of brand-name prescription drugs is rising at more than 10 times the rate of inflation. Part of a yearlong investigation into drug companies, McCaskill also issued a report in February linking drug manufacturers, doctors and advocacy groups to a national opioid addiction crisis. -
Less than 2 percent of patients return unused opioids for proper disposal
Mar 28, 2018 | North State Journal
By Staff
On Tuesday, Serenity House in Concord outside of Charlotte opened its doors to policymakers to discuss ways to tackle opioid addiction. In a roundtable with local leaders, Congressman Richard Hudson (NC-08) heard from administrators of the substance abuse rehabilitation center on their front-lines perspective. -
Cigna Says It Reduced Opioid Use By 25%
Mar 28, 2018 | Forbes
By Matthew Harper
Cigna, one of America's largest health insurers, says it has reduced the use of prescription opioids among its members by 25%. -
MANY E.R. DOCTORS UNDERESTIMATE HOW MANY OPIOIDS THEY PRESCRIBE
Mar 28, 2018 | Pacific Standard (CA)
By Tom Jacobs
Self-deception can often lead to negative consequences, as anyone who tells themselves they eat healthy, only to be shocked when they step on a scale, can attest. But the problem is more serious when the un-self-aware person is a physician who believes they are careful in prescribing opioids. -
Congress is feeding opioid addiction with this bill. Why haven't they repealed it yet? (Opinion)
Mar 28, 2018 | USA Today
By Reps. Jim Cooper & Tom O'Halleran
The opioid epidemic continues to rage across America, tearing families and communities apart. In 2016, 64,070 Americans died from drug overdose, usually with opioids. That’s more than the entire number of Americans killed in the Vietnam War. Today, drugs are more dangerous than traffic accidents. -
Will PBMs Be the Next Target of Opioid Lawsuits? (Opinion)
Mar 28, 2018 | Managed Healthcare Executive
By Karen Appold
Although suing physicians and pharmacists over the opioid crisis is nothing new, up until now pharmacy benefit managers (PBMs) have been off the radar screen. But in February, a south Texas county included the three largest PBMs—CVS, Express Scripts, and OptumRx as well as some smaller ones operating in Texas—in a nationwide lawsuit focusing on the opioid epidemic because of their role in allowing access to prescription opioids. -
Trump announces temporary opioid-abuse memorial outside of White House
Mar 27, 2018 | The Hill
By Luis Sanchez
The White House announced on Tuesday that it will host a memorial for opioid abuse victims near the White House next month. -
Montgomery County files federal lawsuit against opioid companies
Mar 27, 2018 | Clarksville Now (TN)
By Nicole June
Montgomery County has filed a lawsuit in U.S. District Court against a list of pharmaceutical companies that manufacture and distribute opioids. -
Montgomery County sues opioid makers, distributors in federal court
Mar 27, 2018 | The Leaf Chonicle (TN)
By Stephanie Ingersoll
Montgomery County filed a lawsuit in federal court Monday against a number of pharmaceutical companies and distributors it claims "aggressively pushed highly addictive, dangerous opioids." -
Lawsuit blames pharmaceutical companies for opioid epidemic
Mar 27, 2018 | WKRN (TN)
By Staff
Montgomery County is suing several pharmaceutical companies, claiming they are responsible for the opioid epidemic. -
Dougherty Co. seeks litigation on opioid crisis
Mar 28, 2018 | WTOC (GA)
By Ashley Bohle
The opioid crisis is taking many neighborhoods and cities across the country by storm. -
Cook County sues over opioid epidemic
Mar 27, 2018 | Valdosta Daily Times (GA)
By Terry Richards
Cook County has filed a lawsuit against two dozen pharmaceutical companies, holding them responsible for the opioid epidemic spreading through the U.S. -
City of Logan files suit against opioid manufacturers and distributors
Mar 27, 2018 | WSAZ (WV)
By Staff
The city of Logan has joined in the lawsuit against manufacturers and distributors of opioids, according to a news release from the city. -
R.I. cities and towns sue drug companies over opioid epidemic
Mar 27, 2018 | Providence Journal (RI)
By Katie Mulvaney
Twenty-six Rhode Island cities and towns are suing major drug manufacturers, accusing them of conspiring to generate enormous profits while spurring the nationwide opioid epidemic. -
R.I. Cities And Towns Sue Makers Of Prescription Opioids
Mar 28, 2018 | Rhode Island Public Radio
By Lynn Arditi
More than two dozen Rhode Island cities and towns have joined a growing legal attack against the manufacturers and wholesalers of prescription opioids. -
Town considering legal action on opioid crisis
Mar 27, 2018 | Wicked Local Falmouth (MA)
By Ryan Bray
Town officials in Falmouth have long wrestled with how to manage the still-growing problem of opioid abuse. Now they’re exploring the possibility of fighting the battle in court. -
Churchill County considers involvement in statewide opioid lawsuit
Mar 27, 2018 | Nevada Appeal (NV)
By Molly Moser
In the fight against Nevada's epidemic of opioid usage, Churchill County—along with other state counties—is considering joining forces with a Las Vegas law firm to file against manufacturers and distributors. -
Opioid lawsuit could harm community investment, GOP leaders say
Mar 28, 2018 | Michigan Live (MI)
By Malachi Barrett
Next week, Kalamazoo County leaders will discuss joining Michigan cities and counties in a lawsuit against some of the largest drug makers and pharmacies in the world. -
Humboldt County moves to sue Big Pharma; pot tax changes, interim chief probation officer OK’d
Mar 28, 2018 | Eureka Times Standard (CA)
By Will Houston
The Humboldt County Board of Supervisors gave the OK on Tuesday to hire a Seattle-based law firm to join in litigation claiming pharmaceutical companies and distributors misled the public on the addictive nature of opioid medication. -
FOX 17 This Morning
Mar 28, 2018 | Nashville, TN
By WZTV (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33891062?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
News 2 at 5pm
Mar 27, 2018 | Nashville, TN
By WKRN (ABC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891104?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
Good Day Oregon at 6am
Mar 28, 2018 | Portland, OR
By KPTV (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33891072?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
Today in Georgia
Mar 28, 2018 | Albany, GA
By WALB (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891080?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
WSAZ NewsChannel 3 Today
Mar 28, 2018 | Charleston, WV
By WSAZ (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891086?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
WJZ News at 5:30AM
Mar 28, 2018 | Baltimore, MD
By WJZ (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33891089?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
Newschannel 3 at 5am
Mar 28, 2018 | Grand Rapids, MI
By WWMT (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33891092?token=468a010d-c0a7-4369-a01a-17308ce8fc0b -
News Channel 3 at 11
Mar 28, 2018 | Eureka, CA
By KIEM (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891095?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Commentary and FYIs
Southeast (TN, GA, WV)
Northeast (RI, MA)
Southwest (NV)
Midwest (MI)
West (CA)
Broadcast Media Coverage
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Medicare Is Cracking Down on Opioids. Doctors Fear Pain Patients Will Suffer.
Mar 28, 2018 | New York Times
By Jan Hoffman
Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers.
Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction.
But the proposal has also drawn a broad and clamorous blowback from many people who would be directly affected by it, including patients with chronic pain, primary care doctors and experts in pain management and addiction medicine.
Critics say the rule would inject the government into the doctor-patient relationship and could throw patients who lost access to the drugs into withdrawal or even provoke them to buy dangerous street drugs. Although the number of opioid prescriptions has been declining since 2011, they noted, the rate of overdoses attributed to the painkillers and, increasingly, illegal fentanyl and heroin, has escalated.
“The decision to taper opioids should be based on whether the benefits for pain and function outweigh the harm for that patient,” said Dr. Joanna L. Starrels, an opioid researcher and associate professor at Albert Einstein College of Medicine. “That takes a lot of clinical judgment. It’s individualized and nuanced. We can’t codify it with an arbitrary threshold.”
Underlying the debate is a fundamental dilemma: how to curb access to the addictive drugs while ensuring that patients who need them can continue treatment.
The rule means Medicare would deny coverage for more than seven days of prescriptions equivalent to 90 milligrams or more of morphine daily, except for patients with cancer or in hospice. (Morphine equivalent is a standard way of measuring opioid potency.)
According to Demetrios Kouzoukas, the principal deputy administrator for Medicare, it aims to further reduce the risk of participants “becoming addicted to or overdosing on opioids while still maintaining their access to important treatment options.”
The Centers for Medicare and Medicaid Services estimates that about 1.6 million patients currently have prescriptions at or above those levels. The rule, if approved as expected at the end of a required comment and review period, would take effect on Jan. 1, 2019.
Dr. Stefan G. Kertesz, who teaches addiction medicine at the University of Alabama at Birmingham, submitted a letter in opposition, signed by 220 professors in academic medicine, experts in addiction treatment and pain management, and patient advocacy groups.
His patients include formerly homeless veterans, many of whom have a constellation of physical and mental health challenges, and struggle with opioid dependence. For them, he said, tapering opioids does not equate with health improvement; on the contrary, he said, some patients contemplate suicide at the prospect of suddenly being plunged into withdrawal.
“A lot of the opioid dose escalation between 2006 and 2011 was terribly ill advised,” Dr. Kertesz said. “But every week I’m trying to mitigate the trauma that results when patients are taken off opioids by clinicians who feel scared. There are superb doctors who taper as part of a consensual process that involves setting up a true care plan. But this isn’t it.”
Some two dozen states and a host of private insurers have already put limits on opioids, and Medicare has been under pressure to do something, too. Last July, a report by the inspector general at the Department of Health and Human Services raised concerns about “extreme use and questionable prescribing” of opioids to Medicare recipients. In November, a report from the Government Accountability Office took Medicare to task, urging greater oversight of opioid prescriptions.
If the rule takes effect, Mark Zobrosky’s experience could be a harbinger for many patients. Mr. Zobrosky, 63, who lives in the North Carolina Piedmont, takes opioids for back pain, which persists despite five surgeries and innumerable alternative treatments. He has an implanted spinal cord stimulator that sandpapers the edge off agony, and has broken four molars from grinding because of pain, he said. He receives Medicare as a result of his disability, including a private plan that pays for his drugs.
He submits to random urine tests and brings his opioids to his doctor to be counted every month. To prepare for mandatory reductions, his doctor has tapered him down to a daily dose equivalent of about 200 milligrams of morphine. (Mr. Zobrosky has a large frame; doctors say that opioid tolerance depends on many factors — one person’s 30 milligrams is another person’s 90.)
In February, Mr. Zobrosky’s pharmacist told him that his insurance would no longer cover oxymorphone. His out-of-pocket cost for a month’s supply jumped to $1,000 from $225, medical records show. “I can’t afford this for very long and I’m nervous,” he said.
A Medicare official who would speak only on background said that the limit for monthly high doses was intended not only to catch doctors who overprescribe, but also to monitor patients who, wittingly or not, accumulate opioid prescriptions from several doctors. When the dose is flagged, the pharmacist or patient alerts the doctor.
But it falls to pharmacists to be the bad-news messengers. James DeMicco, a pharmacist in Hackensack, N.J. who specializes in pain medications, said that negotiating opioid insurance rejections for patients was already “beyond frustrating.” He spends hours shuttling between doctors and insurers. “My heart goes out to patients because they feel stigmatized,” he said.
Dr. Anna Lembke, an addiction medicine expert at Stanford, sees merit in the intent of the proposed rule, if not its design.
“The C.D.C. declared a drug epidemic in 2011, which they unequivocally and rightly attributed to overprescribing,” she said. “Without external limits, I do not believe that prescribers will be able to limit their prescribing to the extent necessary to address this public health crisis.”
But, she added, Medicare also needed to establish a reasonable grace period to allow patients on high doses to taper down safely.
According to a draft of the rule, when a high-dose prescription is rejected, a doctor can appeal, asserting medical necessity — although there is no guarantee that the secondary insurer covering the drugs under Medicare would relent. A pharmacist may fill a one-time, emergency seven-day supply.
Opponents of the new limit say that doctors are already overwhelmed with time-consuming paperwork and that many will simply throw up their hands and stop prescribing the drugs altogether.
A delay or denial would put chronic pain patients — or those with inflammatory joint diseases, complex shrapnel injuries or sickle cell disease — at risk of precipitous withdrawal and resurgence of pain, doctors said.
The Medicare proposal relies on guidelines from the Centers for Disease Control and Prevention that say doctors should not increase an opioid to a dose that is the equivalent of 90 milligrams of morphine.
But experts say that Medicare misread the recommendations — that the C.D.C.’s 90-milligram red flag is for patients in acute pain who are just starting opioid therapy, not patients with chronic pain who have been taking opioids long-term. The acute pain patient, the guidelines say, should first be offered treatments like acetaminophen or ibuprofen. A short course of a low-dose opioid should be a last resort.
“We didn’t take a specific position on people who were already on high doses,” said Dr. Lewis S. Nelson, the chairman of emergency medicine at Rutgers New Jersey Medical School and University Hospital, who worked on the guidelines.
“We did say that established, high-dose patients might consider dosage reduction to be anxiety-provoking, but that these patients should be offered counseling to re-evaluate,” he added. “There is a difference between a C.D.C. guideline for doctors and a C.M.S. hard stop for insurers and pharmacists.”
Dr. Erin E. Krebs recently released a comprehensive study showing that patients with severe knee pain and back pain who took opioid alternatives did just as well, if not better, than those who took opioids. Nonetheless, she and seven others who worked on the C.D.C. guidelines signed the letter opposing the Medicare rule.
“My concern is that our results could be used to justify aggressive tapering or immediate discontinuation in patients, and that could harm people — even if opioids have no benefit for their pain,” said Dr. Krebs, an associate professor of medicine at the University of Minnesota.
“Even if we walk away from using opioids for back and knee pain, we can’t walk away from patients who have been treated with opioids for years or even decades now,” she added. “We have created a double tragedy for these people.”
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Litigation Plays an Important Role in Addressing the Opioid Crisis, Gluck Says In Coif Speech
Mar 27, 2018 | Georgia State University
By Stacey Evans
Just as there are multiple causes that led to the opioid crisis, there are multiple intersections of response needed to address it, said Abbe R. Gluck, professor of law and the faculty director of the Solomon Center for Health Law and Policy at Yale Law School at Georgia State Law’s Order of the Coif Distinguished Visitor Lecture on March 27.
“Law alone can’t solve a public health crisis of this scale, but as lawyers, our hope is law whether legislative, regulatory or litigation can be as productive a partner as possible,” she said.
One important way litigation is helping is by framing a narrative about responsibility in the opioid crisis. Initially, lawsuits were primarily brought against drug manufacturers and doctors, but plaintiffs have begun to cast a broader net, holding a lot more entities responsible, including pharmacies and drug distributors.
“These entities might not have seen their role before to watch and raise red flags, but now with lawsuits and settlements they may be re-conceiving how they see their role going forward,” Gluck said.
The same is true for the Joint Commission, which is revising its pain management standards because of a lawsuit alleging it downplayed the negative effects of opioids, among other things.
But the wide net of responsible parties also makes litigation strategy difficult.
“Courts have already expressed concern that liability is going to be hard to find for any one kind of defendant because there are so many different links of the causative chain,” Gluck said.
“Doctors say they are prescribing a drug dually approved by the FDA. Distributors argue that doctors and patients with substance abuse disorders are links between them and the product,” Gluck said. “CVS argues that it’s further down the line and cannot possibly be liable for any particular dent.”
This complex chain of responsibility differentiates opioid crisis litigation significantly from the public health litigation to which it is most often compared, big tobacco.
“As in the case of opioids, the tobacco cases were brought largely by states to address a massive public health issue. Some of the experience of the tobacco has raised similar concerns in opioids,” Gluck said.
For example, many think that the settlements in tobacco cases were too low, and when they were received they weren’t used for counter-prevention or public health measures. Another criticism of big tobacco cases is that lawyers settled early for huge rewards rather than push for change that would truly protect public health. Similar concerns are being raised regarding opioid litigation.
At the same time, the opioid crisis has significant differences from tobacco that complicates the litigation. Along with the large chain of responsible actors, opioids have been approved as safe, effective and needed, unlike tobacco.
The most significant development in the opioid crisis is the consolidation of lawsuits into a multi-district litigation (MDL), the same type of litigation used for the NFL concussion cases. The MDL has been assigned to U.S. District Judge Dan Polster of the Northern District of Ohio, and a settlement conference is scheduled for May. Cases continue to be added to the docket every week.
More than 97 percent cases in MDL settles in the MDL court, Gluck said. “The nature of cases that tend to be consolidated in MDLs are huge sprawling cases that pose intractable numbers with intractable problems. The only way to get relief is to have some kind of universal settlement.”
Based on statements from Polster, Gluck said the court is going to take more of a legislative than litigation approach to the crisis.
“This is a problem-solving endeavor, it’s not litigation,” she said.
Settlement seems likely, but the question is whether it will be enough—will action specifically be directed to populations in need.
“If the remedy isn’t efficient, all this energy focused on the litigation could have the detrimental effect of taking the wind out of the sail of what would been more positive change,” Gluck said. “Either way, litigation has certainly set the agenda and raised the profile of the crisis.”
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Mar 26, 2018 | U.S. Senate Committee on Health, Education, Labor and Pensions
By Sen. Lamar Alexander (R-TN)
Senate health committee Chairman Lamar Alexander (R-Tenn.) today released two discussion drafts of legislation to improve the Food and Drug Administration’s (FDA) ability to address the opioid crisis.
“The Senate health committee has held six bipartisan hearings so far this Congress on nearly every aspect of the opioids crisis, to inform legislation to better help states and communities on the front lines,” Alexander said. “I want to ensure that the Food and Drug Administration has every tool it needs to fight the opioid crisis, and the draft legislation released today will take the next step towards making that possible.”
Alexander continued: “The first proposal would require drug manufacturers to package certain opioids in a set dose, like a blister pack, which will make it simpler for doctors to write prescriptions for smaller numbers of opioids. It would also encourage manufacturers to provide a safe way to dispose of leftover opioids along with the prescription a patient picks up—to prevent unused opioids from ending up in the wrong hands. A second proposal would ensure FDA can spend the $94 million included in the omnibus bill Congress passed last week to upgrade detection technology, laboratory capacity, and import facilities to better identify illegal drugs, including synthetic opioids such as fentanyl, at the border.”
Improving FDA authorities to address the opioid crisis
First, to help limit overprescribing, this legislation would give the Food and Drug Administration (FDA) the authority to require drug manufacturers to package certain opioids in blister packs, allowing for a set dose – for example, a 7 day supply. This would make it simpler for a doctor to write a prescription for a smaller number of opioids, easier for pharmacists to fill, and will help to prevent overprescribing and diversion of unused medicine, for example, preventing unused medicines from being sold or abused.
Second, to prevent unneeded or unused opioids from falling into the wrong hands, this legislation would encourage manufactures to provide a safe way to dispose the leftover drugs along with the packaging.If a mom receives a 30 day opioid supply after knee surgery, but only takes 15 days’ worth, this would make it easier for her to safely dispose of the unneeded opioids to prevent her child from finding them and using the remaining opioids.
Text of the discussion draft is available here.
Improve coordination between the Food and Drug Administration (FDA) and Customs Border Protection (CBP)
To improve ability to find and seize illegal drugs, such as fentanyl, at the border, this legislation would:Ensure FDA and CBP detection technology and testing equipment used at the border is interoperable and allows near-real-time data sharing for faster and smarter detection of new substances coming across the border, such as synthetic fentanyl.Make available additional trained canine units, including trained canine officers, are available at import facilities to increase detection and screening capabilities.Upgrade FDA facilities and provide appropriate equipment, laboratory capacity, and physical infrastructure improvements, which may include security upgrades, to improve capacity to examine and detect illegal opioids at import sites, such as International Mail Facilities.Require a progress report within six months on the implementation of these new authorities, including progress made towards near-real-time information sharing and the interoperability of technology used at the import sites.
Text of the discussion draft is available here.
The Senate health committee has held a series of six bipartisan hearing so far this Congress to examine ways the federal government can be a better partner for states on the front lines of the opioid crisis.
On October 5, 2017, the Senate health committee held the first hearing of the series which focused on the federal response to the opioid crisis, and on November 30, 2017, the committee heard from witnesses representing states, communities, and providers on what they are doing and what, if any, new authorities they need from the federal government to fight the crisis. On January 9, 2018, the committee heard from author Sam Quinones, who has extensively researched and written about the opioid crisis. On February 8, 2018, the committee held a hearing to look the effects the opioid crisis has on children and families. On February 27, 2018, the committee held a hearing on the role technology and data play in responding to the crisis. On March 8, the committee heard from some of the nation’s governors about how they are coming up with innovative solutions and leading the fight against the unique problems their states face in the midst of the opioid crisis.
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McCaskill Report Finds Drug Prices Outpace Inflation
Mar 27, 2018 | St. Louis Patch (MO)
By J. Ryne Danielson
A new report by Missouri Democratic Sen. Claire McCaskill released March 26 indicates the cost of brand-name prescription drugs is rising at more than 10 times the rate of inflation. Part of a yearlong investigation into drug companies, McCaskill also issued a report in February linking drug manufacturers, doctors and advocacy groups to a national opioid addiction crisis.
"Can you imagine if you went to an auto dealership and last year's exact model was being sold at a 20 percent mark-up, and then you went back the next year and it had happened again?" McCaskill said. "That's exactly what's happening in the prescription drug industry, where the cost of identical drugs skyrockets year after year. Everywhere I go Missourians are angry and upset about these price increases. This report demonstrates that the pricing decisions made by these drug companies are outrageous—and I've never shied away from taking on this massive industry on Missourians' behalf."
The report examined the top 20 most commonly prescribed brand-name prescription drugs used by seniors and found price increases for all of them. On average, the report states, the drugs became 12 percent more expensive every year.
More than half the drugs examined saw price increases of more than 50 percent over five years and about a quarter doubled in price. One saw a dramatic spike in cost of 477 percent over five years.
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Less than 2 percent of patients return unused opioids for proper disposal
Mar 28, 2018 | North State Journal
By Staff
On Tuesday, Serenity House in Concord outside of Charlotte opened its doors to policymakers to discuss ways to tackle opioid addiction. In a roundtable with local leaders, Congressman Richard Hudson (NC-08) heard from administrators of the substance abuse rehabilitation center on their front-lines perspective.
“Serenity House is a great example of that and a beacon of hope for people struggling with addiction. I’ll continue to support our local experts and work with them and others on the frontlines to confront these challenges in our community,” said Hudson.
The visit followed two-day hearing last week in Washington, D.C., of the U.S. House Health Subcommittee. Dr. John Holladay, CEO of DisposeRx based in Southern Pines, spoke to the lawmakers about educating the public on proper disposal and handling of medications to help stem the explosion of opioid addiction. DisposeRx makes a powder that mixes with water inside the pill bottle and destroys any unused opioids and makes them biodegradable.
“The failure to properly dispose of unused or expired prescription drugs from our home medicine cabinet, managed care facilities, hospitals and hospice centers has dramatically contributed to the rapid increase of prescription drug abuse, accidental poisonings, opioid overdoes and the pollution of our nation’s public water supplies,” Holladay told the congressional committee last week.
Hudson sits on the subcommittee which is considering two dozen bills aimed at improving public health, including Hudson’s own measure that would direct the FDA to set up a program for return of unused Schedule II drugs and would task the General Accounting Office (GAO) with studying new technologies for safe disposal of medications.
A survey in the Journal of Drug Abuse revealed that only 1.4 percent of consumers returned their unused medications to their pharmacy. About 50 percent throw their medications in the trash and more than a third dispose of their medications in the sink or toilet.
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Cigna Says It Reduced Opioid Use By 25%
Mar 28, 2018 | Forbes
By Matthew Harper
Cigna, one of America's largest health insurers, says it has reduced the use of prescription opioids among its members by 25%.
That percent reduction had been set as a goal in May 2016 by the $41.6 billion (sales) Bloomfield, Conn.-based firm. But Cigna had expected to take three years to reduce opioid prescriptions that much. Instead, it did it in two.
"A big part of this chapter, of the intensity of our focus, was to reduce the risk for future onset of addiction by decreasing the number of people and decreasing the availability of these highly addictive opioids," said David Cordani, Cigna's chief executive officer.
The 25% figure takes into account both the number of opioids prescribed by doctors treating patients covered by Cigna and their strength, via a measure of morphine equivalent doses. A more potent drug, like Oxycontin, would represent a higher number of morphine equivalent doses. Opioid prescriptions have been dropping nationwide, though not that fast, experts say.
Cigna says that the reduction was not caused by simply denying claims for opioids, but by its staff physicians carefully reaching out to doctors to make sure they understood how their prescribing behavior compared to the recommendations of the Centers for Disease Control and Prevention and the behavior of other prescribers. "The ability for physicians to understand how their prescribing patterns align with the standards really allows physicians to understand their patterns better and ultimately provide the best care for their patients," says Douglas Nemecek, the chief medical officer of Cigna's behavioral health business.
David Juurlink, a health policy researcher at the University of Toronto, writes via email that there is no doubt doctors have prescribed opioids freely over the past twenty years, and that there is little doubt that fewer patients starting the medicines at lower doses will pay health dividends. But he worries about patients who have become dependent on high doses of opioids. "[A] ham-handed 25% reduction in opioid prescribing exposes them to the potential risk of opioid withdrawal if the doctor, for whatever reason, lowers their doses unilaterally too quickly," he says. That, in turn, can increase the risk that they will become addicted.
Nemecek says that Cigna "really worked" at making sure patients received "appropriate, evidence-based care for addiction." This includes removing requirements that physicians get prior approval before prescribing drugs like Suboxone, which can help patients stop using opioids. Nemecek also says that its too early to tell what effect the new initiatives have on patients seeking help with opioid dependence, or on overdoses, but that Cigna knows it has more work to do.
"I'm pleased Cigna is working on this," says Andrew Kolodny, the Co-Director of Opioid Policy Research at the Heller School for Social Policy and Management. He hopes the insurer will be able to use its data to tell others which strategy works best. But he also had a caution: Cigna, based on conversations with experts a year ago, pegged the 25% reduction as enough to bring opioid use in line with what it was before the current opioid epidemic. Kolodny's math is different. He says that would require more like a 75% reduction.
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MANY E.R. DOCTORS UNDERESTIMATE HOW MANY OPIOIDS THEY PRESCRIBE
Mar 28, 2018 | Pacific Standard (CA)
By Tom Jacobs
Self-deception can often lead to negative consequences, as anyone who tells themselves they eat healthy, only to be shocked when they step on a scale, can attest. But the problem is more serious when the un-self-aware person is a physician who believes they are careful in prescribing opioids.
A new study of emergency room doctors finds nearly two-thirds prescribe more of the highly addictive pain relievers than they realize.
"Most believe they are doing the right thing," said Sean Michael of the University of Colorado School of Medicine, the study's lead author. "We need to directly address this thinking to be sure they are not part of the problem."
The study, published in the journal Academic Emergency Medicine, featured 109 emergency-medicine providers at four hospital emergency departments—two in urban locations, one in a suburban community, and another in a rural area.
The researchers reviewed the prescribing history of 51 of the providers over the previous year, focusing on opioids (but excluding Schedule V drugs such as cough medicines or antidiarrheals). "To account for differences in formulation, potency, pill strength, and dosing frequency," they write, "we calculated the total morphine milligram equivalents for each opioid prescription."
They then presented each provider with a graph showing the rate of opioid prescriptions for the department, and asked them to estimate where they fall.
"For most providers, we identified striking gaps in prescribing self-awareness," the researchers report. "Among all intervention participants, 73 percent of attending physicians and advanced practice providers (that is, nurse practitioners and physicians' assistants), and 27 percent of residents, (significantly) underestimated their prescribing rank among their peers."
In contrast, "only five providers—three residents and two attendings—consistently overestimated" where they stood in relation to their colleagues.
The encouraging news is that confronting them with their actual data made a difference in their subsequent prescribing behavior.
"After seeing their real data," Michael reports, "the people with inaccurate self-perceptions, on average, had 2.1 fewer opioid prescriptions per 100 patients six months later." That number increased slightly, to 2.2 fewer prescriptions, after 12 months.
"It is likely that most emergency department providers view their opioid prescribing as similar to, or less than, their peers," the researchers conclude. Shattering that illusion appears to have spurred "robust behavior change for a subset of providers who may have otherwise had difficulty internalizing the need to change."
While this is a small study, it could easily be replicated in emergency rooms across the country. And given estimates that only 5 percent of opioid prescriptions emerge from such settings, it's worth considering how this intervention could be applied to other physicians as well.
A lot of doctors, it seems, suffer from Lake Wobegon syndrome. But in truth, when it comes to careful prescription of opioids, not every practitioner is above average.
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Congress is feeding opioid addiction with this bill. Why haven't they repealed it yet? (Opinion)
Mar 28, 2018 | USA Today
By Reps. Jim Cooper & Tom O'Halleran
The opioid epidemic continues to rage across America, tearing families and communities apart. In 2016, 64,070 Americans died from drug overdose, usually with opioids. That’s more than the entire number of Americans killed in the Vietnam War. Today, drugs are more dangerous than traffic accidents.
The job of Congress is to stop the epidemic, or at least ease the crisis. The last thing Congress should do is make it worse.
But, in 2016, Congress passed legislation that reduced the vigilance of federal watchdogs over drug companies that sell opioids. The “Ensuring Patient Access and Effective Drug Enforcement Act” was a bill that sounded good but, in reality, rendered government watchdogs toothless.
Because the legislation had a good title and was described as uncontroversial by its sponsors, the legislation passed the House and Senate by unanimous consent and was signed into law in April 2016.
Fortunately, an October 2017 joint investigation by The Washington Post and “60 Minutes” revealed that the law actually restricts the Drug Enforcement Agency’s ability to investigate and discipline opioid distributors suspected of illegal behavior. Specifically, the law limited the DEA’s ability to freeze large suspicious narcotics shipments.
For example, two pharmacies in West Virginia ordered enough opioid pills to supply the entire state. How could drug stores in a county of 3,000 people order 20.8 million opioid pills? That is a sure sign of wrongdoing.
The bill’s passage was a terrible mistake that Congress has refused to correct. There is no excuse for inaction. Congress must vote to repeal this law now.
After the “Ensuring Access and Effective Drug Enforcement Act” was signed into law in April 2016, the opioid crisis only worsened across America, including in our home states of Tennessee and Arizona. In 2016, the rate ofdrug overdose deaths in Tennessee reached a record level; 73% of the deaths were due to opioid abuse. In Arizona, the rate of opioid-related deaths jumped by 74% from 2012 to 2016.
We recognize that the causes of the opioid epidemic are multi-faceted and repealing a single bad law won’t be enough to reverse the alarming trends. However, this is the most basic, common sense step Congress can take to undo a grave mistake. The first rule of medicine is “to do no harm.” That’s why the Blue Dog Coalition’s Special Task Force on Rural America has called for repeal the “Ensuring Patient Access and Effective Drug Enforcement Act.”
ongress has had six months to repeal the bad law since the media revealed the congressional mistake. Why is the majority in Congress taking so long to correct its error? Every day more drug shipments are being made to pharmacies across America, even though the shipment volume clearly exceeds the legitimate opioid needs of local patients. Our job as members of Congress is to stand up for the families we represent, not the special interests.
Republicans and Democrats agree that Congress must act now and vote to repeal this bad bill.
Americans deserve better. We deserve a government that works for us – not against us.
Rep. Jim Cooper (D-TN) and Rep. Tom O’Halleran (D-AZ) are members of the Blue Dog Coalition. Rep O’Halleran is the chairman of the Blue Dog Special Task Force on Rural America, an effort to find bipartisan policy solutions for rural communities.
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Will PBMs Be the Next Target of Opioid Lawsuits? (Opinion)
Mar 28, 2018 | Managed Healthcare Executive
By Karen Appold
Although suing physicians and pharmacists over the opioid crisis is nothing new, up until now pharmacy benefit managers (PBMs) have been off the radar screen. But in February, a south Texas county included the three largest PBMs—CVS, Express Scripts, and OptumRx as well as some smaller ones operating in Texas—in a nationwide lawsuit focusing on the opioid epidemic because of their role in allowing access to prescription opioids.
PBMs set the rules that determine drug availability and how much patients have to pay out of pocket to get them. So why haven’t they been targeted until now?
Harry Nelson, managing partner, Nelson Hardiman, LLP, a healthcare law firm, says physicians have been targeted based on their role as prescribers and as frontline decision makers with the capability to avoid opioid overprescribing, dependency, and resulting harm. Similarly, pharmacists have been sued because of their roles as dispensers and their capacity to serve as the last safeguard before patients end up at risk from overprescribing.
“While PBMs play a critical role in drug’s pricing and availability, they are not expected to question physician’s therapeutic choices,” Nelson says. “They don’t have the same professional obligations that pharmacists do to avoid suboptimal dispensing choices. As unlicensed entities, they don’t hold individual licenses, as physicians and pharmacists do, so they are not held to the same standard. Their roles and responsibilities are less well-defined, so there is less basis to hold them responsible.”
Nonetheless, PBMs actually have a lot of power, says Christopher J. Metzler, PhD, JD, CEO, Gordium Healthcare, a multidisciplinary behavioral healthcare organization. They are the middlemen who operate between the doctor, patient, and pharmacy. They provide insurance contracts with pharmacies and can deny a claim’s payment. They have the most to gain from a prescription’s cost.
Given the number of governmental entities now bringing lawsuits, and the limited number of manufacturer and distributor targets, Lawrence Ingram, a partner in the law firm Freeborn & Peters' Litigation Practice Group, and a member of its Insurance and Reinsurance Industry Team, foresees every entity in the distribution chain eventually getting caught up in this type of litigation.
Similar lawsuits likely
In the Texas case, The Webb County lawsuit alleged that PBMs drove the opioid epidemic as a result of increasing profits from the drugs.
Nelson says since it doesn’t cost much to name a PBM as an additional party in litigation, he expects PBMs to increasingly be named in opioid-related lawsuits. “While it takes some creativity to do something new (like looking at PBMs) as a responsible party, my hunch is that other lawyers are likely to learn from this and will be interested in a potential additional source of settlement funds,” he says.
Metzler also expects more PBMs to be sued. “Lawyers who present a well-written and brutal set of discovery questions, review the prescription paper trail, and talk to pharmacies and patients will find a treasure trove of evidence to present to a jury,” he says.
So on what grounds could PBMs be sued? Nelson says PBMs may not hold licenses that impose obligations, but their contractual commitments as intermediaries between health plans and pharmacies provide a potential argument that they also owe responsibility to patients, who are arguably third-party beneficiaries of those contracts. In other words, health plans are contracting with PBMs for the benefit of patients, so PBMs have the responsibility to protect patients from harm. There may also be an argument that PBMs are in a better position than individual pharmacies because of their data access to red flag problematic prescribing practices.
Ingram says allegations would likely be that the PBMs somehow allowed a greater amount of these drug products to be permitted in communities than could be supported by legitimate medical needs.
Likely outcomes
As a novel legal theory, lawyers will have to explain in detail to the courts what PBMs are and how they operate. “Unless lawyers are able to do so and prove causation, this will be a very difficult road to travel,” Metzler says. “As in most novel legal theories, this is a test, the outcome of which is uncertain. It is up to lawyers to educate, persuade, and prove causation.”
In the future, Nelson says PBMs may put additional safeguards in place to scrutinize troubling practices that surface through data, such as potential indicia of excessive prescribing. For patients, getting access to opioids is likely to get even tougher, with another hurdle in the form of PBMs. This may also make opioids more expensive, as PBMs begin to factor in the additional costs and risks associated with opioid prescribing.
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Trump announces temporary opioid-abuse memorial outside of White House
Mar 27, 2018 | The Hill
By Luis Sanchez
The White House announced on Tuesday that it will host a memorial for opioid abuse victims near the White House next month.
“I am very pleased to welcome the opioid memorial to the President's Park in April,” Trump tweeted on Tuesday. “I encourage all to visit and remember those who we have lost to this deadly epidemic. We will keep fighting until we defeat the opioid crisis!”
According to White House press secretary Sarah Huckabee Sanders, the memorial will have 22,000 pills carved with the faces of opioid overdose victims. The memorial will be open to the public from April 12-18.
The memorial, which is a part of the National Safety Council's “Stop Everyday Killers” campaign, will also have a note next to the faces of the victims commemorating their lives.
The White House will work with the National Park Service and the Department of the Interior to host the memorial that will be featured at the Ellipse in President’s Park.
Trump has made fighting the opioid crisis a focus of his domestic policy agenda. Earlier this month he announced a set of proposals to address the crisis.
Some of the more controversial aspects of his plan include imposing the death penalty for large-scale drug dealers and building a wall along the southern border to stop drugs from coming into the country.
“You know, if you shoot one person, they give you life, they give you the death penalty,” Trump said. “These people can kill 2,000, 3,000 people and nothing happens to them. Some countries have a very, very tough penalty, the ultimate penalty. And, by the way, they have much less of a drug problem than we do.”
The president has also pushed to make overdose-reversing drugs — such as naloxone — more readily available.
“These stories are tough to hear, and this exhibit will be an intensely emotional and somber experience,” Sanders said. “But it's also a reminder that lives are at stake, and we must take action to end the plague of addiction that is ravaging communities all across our nation.”
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Montgomery County files federal lawsuit against opioid companies
Mar 27, 2018 | Clarksville Now (TN)
By Nicole June
Montgomery County has filed a lawsuit in U.S. District Court against a list of pharmaceutical companies that manufacture and distribute opioids.
The lawsuit was filed Monday, March 26, 2018.
Court documents say the purpose of the lawsuit, according to Montgomery County, is “to eliminate the hazard to public health and safety caused by the opioid epidemic, to abate the nuisance caused thereby, and to recoup monies that have been spent because of Defendants’ false, deceptive and unfair marketing and/or unlawful diversion of prescription opioids.”
The lawsuit also says that the companies aggressively pushed highly addictive, dangerous opioids and falsely represented to doctors that patients would only rarely succumb to drug addiction.
“The distributors and manufacturers intentionally and/or unlawfully breached their legal duties under federal and state law to monitor, detect, investigate, refuse and report suspicious orders of prescription opiates,” the lawsuit states.
Twenty companies that market or distribute opioids are named in the lawsuit.
The lawsuit seeks economic damages based on the following criteria:
• Costs for providing medical care, additional therapeutic, and prescription drug purchases, and other treatments for patients suffering from opioid-related addiction or disease, including overdoses and deaths
• Costs for providing treatment, counseling, and rehabilitation services
• Costs for providing treatment of infants born with opioid-related medical conditions
• Costs associated with law enforcement and public safety relating to the opioid epidemic
• Costs associated with providing care for children whose parents suffer from opioid-related disability or incapacitationAccording to the organization TN Together, 29 overdose deaths were reported in Montgomery County in 2016 and 15 of those were due to opioids. The state of TN set a record in 2016 with a total of 1,631 overdose deaths.
As of 2016, Tennessee is one of the top three opioid dispensing states based on pill count. Governor Bill Haslam recently released a comprehensive plan to battle the epidemic.
The Montgomery County Health Department, Montgomery County Government, and the Montgomery County Veterans Coalition hosted an Opioid Education Event on January 23, 2018 to address the issue and answer questions about how opioids are affecting the Montgomery County community.
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Montgomery County sues opioid makers, distributors in federal court
Mar 27, 2018 | The Leaf Chonicle (TN)
By Stephanie Ingersoll
Montgomery County filed a lawsuit in federal court Monday against a number of pharmaceutical companies and distributors it claims "aggressively pushed highly addictive, dangerous opioids."
The lawsuit, filed in the U.S. District Court in Nashville, complains there were violations of the Racketeer Influenced and and Corrupt Organizations Act, that the corporations created a "public nuisance," and that they were negligent and misrepresented the danger of taking opioids for chronic pain.
The county claims the defendants' actions caused a financial burden, including the cost for providing medical care for opioid-related addiction or diseases, including overdose and death; the costs for providing treatment; the costs for providing treatment to infants born with opioid-related medical conditions; costs associated with law enforcement and public safety; and the costs of providing care for children whose parents suffer from opioid-related disability or incapacitation.
The lawsuit also "seeks the means to abate the epidemic created by defendants' wrongful and/or unlawful conduct."
It states the county has standing to recover damages as a result of the companies' actions or omissions and to bring the claims under the federal RICO statute, which generally target ongoing criminal organizations.
"The manufacturers aggressively pushed highly addictive, dangerous opioids, falsely representing to doctors that patients would only rarely succumb to drug addiction," the lawsuit states. "These pharmaceutical companies aggressively advertised to and persuaded doctors to prescribe highly addictive, dangerous opioids, turned patients into drug addicts for their own corporate profit."
It says the actions were intentional.
It also claims distributors and manufacturers breached their legal duties under federal and state law to monitor, detect, investigate, refuse and report suspicious orders of prescription opiates.
Distribution into Tennessee and Montgomery County "created the foreseeable opioid crisis and opioid public nuisance for which plaintiff seeks relief."
It names 20 companies, which the lawsuit claims created a hazard to public health and asks the court to eliminate that hazard, abate the nuisance and recoup monies that have been spent because of the defendant's "false, deceptive and unfair marketing/and or unlawful diversion of opioid pills.
Over the last two decades, there has been an increasing abuse and diversion of prescription drugs.
By 2010, it says enough prescription opioids were sold to medicate every adult in the US with a dose of 5 milligrams of hydrocodone every four hours for one month.
In 2011, the U.S. Department of Health and Human Resources declared prescription painkiller overdoses at "epidemic levels," the lawsuit claims.
The death toll has tripled in the last decade with more than 40 people dying from overdoses everyday involving narcotic pain relievers like hydrocodo, methadone, oxycodone and oxymorphone.
"Prescription drug abuse is a silent epidemic that is stealing thousands of lives and tearing apart communities and families across America," the lawsuit says. "Almost 5,500 people start to misuse prescription painkillers every day."
In 2016, drug overdoses killed roughly 64,000 people in the United States, up 22 percent from the previous year.
"Meanwhile, the manufacturers and distributors of prescription opioids extract billions of dollars of revenue from the addicted American public while public entities experience tens of millions of dollars of injury.
Tennessee ranks second in the country in its opioid prescription rate of 142.8 prescriptions written per 100 person. There were 1,186 deaths caused by overdoses in 2017, which set a record in state history. There was also a dramatic jump in deaths associated with heroin, an illegal opioid some turn to as a result of addiction that started with pills.
Tennessee spent more than $422 million on the problem in 2015 alone, according to the lawsuits. It has doubled the number of parents who have lost rights to their children since 2010, the lawsuit says.
In Montgomery County, the Centers for Disease Control estimated 87 opioid prescriptions were dispensed per 100 people in 2016, which is well above the national average of 66.5.
In addition to asking compensatory damages to treat patients suffering from addiction, it claims negligence, civil conspiracy and fraud and misrepresentation. It seeks an unspecified amount of money for punitive damages and asks that the companies be ordered not to engage in unfair or deceptive practices. It also seeks legal and court costs.
The lawsuit asks that the court order the defendants to fund an "abatement fund" to help end the opioid nuisance.
The lawsuit was filed by Montgomery County Attorney Timothy Harvey.
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Lawsuit blames pharmaceutical companies for opioid epidemic
Mar 27, 2018 | WKRN (TN)
By Staff
Montgomery County is suing several pharmaceutical companies, claiming they are responsible for the opioid epidemic.
The federal lawsuit says the companies “aggressively advertised” and persuaded doctors to prescribe opioids to patients.
The lawsuit also says the opioid crisis has put a financial burden on the county and it asks for money to pay for medical care, treatment and law enforcement.
More than a dozen companies are named in the lawsuit.
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Dougherty Co. seeks litigation on opioid crisis
Mar 28, 2018 | WTOC (GA)
By Ashley Bohle
The opioid crisis is taking many neighborhoods and cities across the country by storm.
And leaders here in Dougherty County are preparing to fight this epidemic.
County Commission Chairman Chris Cohilas said commissioners plan to file a lawsuit against the pharmaceutical industry and pill abusers.
On Monday, five different law firms from across the state presented their experience and knowledge to the commissioners.
Now commissioners are considering which law firm they could potentially choose to help ask for damages for Dougherty County.
"I think you have to start discussions with your medical providers as well as law enforcement and sort of infiltrate the issue from all sides," said Cohilas.
The five law firm groups that presented were: Simmons, Hanly, Conroy; Studstill Firm LLP; Blasingame, Burch, Garrard & Ashley PC; The Hatchett Firm; and Vaughn, Wright & Boyer.
Cohilas said they will be looking for expertise and connection to the Southwest Georgia community when choosing a law firm.
"When you go to church and you meet a family, who has buried their 22-year-old son because after he got off of opioids, he then looked for heroin and then he overdoses, that lets you know that that's an issue that needs to be addressed," explained Cohilas.
According to the Department of Health and Human Services, in 2016, 116 people died every day across the U.S. from opioid-related drug overdoses.
County Attorney Spencer Lee said any of the five law firms would serve the community well.
"The litigation will take somewhere between two to three years. So we're way down the line on whether or not the county can show the damages to this community as a result of opioid abuse," stated Lee.
County commissioners have not set a deadline for choosing a firm at this time.
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Cook County sues over opioid epidemic
Mar 27, 2018 | Valdosta Daily Times (GA)
By Terry Richards
Cook County has filed a lawsuit against two dozen pharmaceutical companies, holding them responsible for the opioid epidemic spreading through the U.S.
The lawsuit, filed March 9 in federal court, claims the manufacturers of opioids used aggressive advertising and persuasion tactics to convince doctors to prescribe the drugs as painkillers.
"The manufacturers aggressively pushed highly addictive, dangerous opioids, falsely representing to doctors that patients would only rarely succumb to drug addiction," the lawsuit states.
The lawsuit also targets opioid distribution companies, claiming they failed in their duty to report suspicious purchases to the authorities. Three of the defendants — AmerisourceBergen Drug Corporation, Cardinal Health, Inc., and McKesson Corporation — control about 85 percent of the market for prescription opioids, according to the lawsuit.
Dwight Purvis, chairman of the Cook County Board of Commissioners, said the county is joining a class-action lawsuit with other counties.
"The board unanimously voted to join," he said.
Opioid abuse played a factor in the closing of Cook County's only emergency room earlier this year, the chairman said. The ER at Cook Medical Center closed in February, forcing those with emergencies to travel to an emergency room outside of the county.
"Some people would show up 12 times a month at the ER just wanting painkillers," Purvis said.
On a more personal note, the chairman said a factor in his vote for the lawsuit was the death of an out-of-state friend who overdosed on opioids.
The lawsuit calls for the defendants to compensate Cook County for costs incurred by the opioid epidemic, such as medical care, counseling and law-enforcement costs, as well as attorney's fees and court costs.
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City of Logan files suit against opioid manufacturers and distributors
Mar 27, 2018 | WSAZ (WV)
By Staff
The city of Logan has joined in the lawsuit against manufacturers and distributors of opioids, according to a news release from the city.
It comes in response to the deadly opioid crisis throughout the country.
Last year, Logan County joined other counties and municipalities in filing suit.
“It is difficult to see the grip that this epidemic has on the people of our area, good people, it doesn’t discriminate,” Logan Mayor Serafino Nolletti said. “We have lost entirely too many.”
The lawsuit seeks damages, including expenses that have accumulated from first responder costs.
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R.I. cities and towns sue drug companies over opioid epidemic
Mar 27, 2018 | Providence Journal (RI)
By Katie Mulvaney
Twenty-six Rhode Island cities and towns are suing major drug manufacturers, accusing them of conspiring to generate enormous profits while spurring the nationwide opioid epidemic.
Warwick, Cranston, North Providence, Charlestown, Jamestown and a host of other towns filed suit this week in U.S. District Court arguing the AmerisourceBergen Drug Corp., Johnson & Johnson, and its subsidiary Janssen Pharmaceuticals, and other drug companies engaged in a racketeering conspiracy by manufacturing and marketing the powerful narcotics at devastating societal costs.
The lawsuit asserts that the companies -- the five largest producers of prescription narcotics and three largest wholesale drug distributors -- engaged in deceptive marketing campaigns aimed at increasing opioid use. The cities and towns say they seek to “eliminate the hazard to public health and safety” and abate the nuisance caused by the companies. They are seeking unspecified damages.
The local governments are working with a consortium of law firms nationwide to “hold pharmaceutical wholesale distributors accountable for failing to do what they were charged with doing under the federal Controlled Substances Act – monitor, identify and report suspicious activity in the size and frequency of opioid shipments to pharmacies and hospitals,” Eva Mancuso, who is serving as Rhode Island counsel, said in a news release.
“Our cities and towns have had enough. It is time to go on offense and force these drug companies to follow the law and pay for the damages that we have incurred as a result of their conduct,” Mancuso said. “We are determined to do everything in our power to stop this epidemic from further destroying the lives of the people of Rhode Island. Ending this crisis is going to take a major collective effort. Part of that effort must include accountability for the for-profit companies who fueled this epidemic.”
The towns participating include Barrington, Bristol, Burrillville, Central Falls, Charlestown, Coventry, Cranston, Cumberland, East Providence, Foster, Glocester, Hopkinton, Jamestown, Johnston, Narragansett, Newport, North Kingstown, North Providence, Pawtucket, Richmond, Smithfield, South Kingstown, Warwick, West Greenwich, West Warwick, and Westerly.
“The group, which represents 80 percent of the state’s population, is joining a growing list of local governments across the country that are working to hold accountable the companies responsible for dumping millions of dollars’ worth of prescription opiates into their communities,” Mancuso said.
There are more such lawsuits to come, she said.
In filing suit, the Rhode Island cities and towns lead New England in joining communities nationwide targeting pharmaceutical companies for allegedly driving the opioid epidemic.
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R.I. Cities And Towns Sue Makers Of Prescription Opioids
Mar 28, 2018 | Rhode Island Public Radio
By Lynn Arditi
More than two dozen Rhode Island cities and towns have joined a growing legal attack against the manufacturers and wholesalers of prescription opioids.
The suit filed this week in federal court, Providence accuses drug makers of engaging in deceptive marketing to generate “wildly enormous profits” at the expense of public health.
“I’ve spent the last several months going from each town council, explaining to them what we were doing nationally and asking them to sign on,’’ Eva Marie Mancuso, the Providence lawyer representing 26 communities in the lawsuit. “So we felt that since we already had 80 percent of the state it was time to file.”
Warwick, Cranston, North Providence and Pawtucket are among the communities that have joined the case, Mancuso said. Providence and Woonsocket have not joined, she said, but could do so later.
The public nuisance and racketeering suit is part of a legal attack coordinated by a personal injury law firm based in Pensacola, Fla. Similar lawsuits have been filed around the country, including West Virginia, which has the nation’s highest opioid overdose rate.
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Town considering legal action on opioid crisis
Mar 27, 2018 | Wicked Local Falmouth (MA)
By Ryan Bray
Town officials in Falmouth have long wrestled with how to manage the still-growing problem of opioid abuse. Now they’re exploring the possibility of fighting the battle in court.
Selectmen on Monday directed Town Manager Julian Suso and Town Counsel Frank Duffy to prepare a recommendation in May on how the town might proceed with potential legal action against pharmaceutical companies for their part in the opioid epidemic, which has touched on communities nationwide.
Duffy said the town has received solicitations from legal consortiums interested in getting Falmouth to join the effort to take legal action against major pharmaceutical companies. Opioid addiction stems from the abuse of prescription drugs in 50 to 80 percent of cases, he said, adding that pharmaceutical companies have a legal responsibility to try and prevent the illegal sale and distribution of their products, as well as warn consumers of the risks of addiction.
“For the most part, the suit is based on the premise that pharma companies have failed in this duty,” Duffy said Monday.
If successful, the town would collect damages relative to the various costs the town incurs in dealing with the opioid problem locally. That includes costs to the police, fire, school, and human services departments, among others, Duffy said.
Specifically Duffy noted that health benefit and workers compensation costs have “incrementally” increased in recent years due to the opioid problem. So to have ambulance costs and the cost of training additional emergency response personnel to address and handle overdoses and other opioid-related problems.
Police resources are meanwhile used to respond to intoxicated drivers, as well as theft and other crimes that can be attributed in part to addiction. Duffy also noted that addicts “seek refuge” in public areas such as libraries and parks.
While the town would be joining other communities in the legal effort, Duffy pointed out that effort is not a class action suit. That’s because different towns incur different costs related to the opioid crisis.
“It’s more a collective effort, not a class action,” he said.
Among the legal options available to the town include a lawsuit from Attorney General Maura Healey on behalf of the state. However, Duffy said that option might not be in the town’s best interest.
“My understanding is there is not a way for individual towns to be plaintiffs in that type of action,” he said.
Another option is for the town to file suit as part of a “multi-district litigtaion”, where towns that are similarly impacted by the crisis take legal action together. Duffy cited one such effort in Cleveland, Ohio, where one judge ordered all cases into mediation.
Duffy and Suso will work on preparing a figure for what the town might expect to receive in damages through the suit. They will also interview representatives from two legal consortiums and present options for proceeding with legal action to selectmen at the board’s second meeting in May, Duffy said.
’I like the idea of interviewing the firms and having them come with a recommendation,” Selectmen Chairman Susan Moran said.
Selectman Samuel Patterson, meanwhile, said regardless of a potential suit, he’s interested in putting a dollar amount to what the opioid problem is costing the town.
“I think the idea of calculating the cost and coming up with a figure is a worthwhile exercise,” he said.
Duffy said the town would pay 25 percent of the cost of any legal effort led by a consortium, with no costs paid up front.
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Churchill County considers involvement in statewide opioid lawsuit
Mar 27, 2018 | Nevada Appeal (NV)
By Molly Moser
In the fight against Nevada's epidemic of opioid usage, Churchill County—along with other state counties—is considering joining forces with a Las Vegas law firm to file against manufacturers and distributors.
The law firm, Eglet Prince, discussed the national opioid impact and encouraged Churchill County Commissioners on Wednesday to file a lawsuit and possibly gain a large settlement for the state.
The firm is offering to pay all costs up front; a budgeted $15 million for the costs of prosecuting the case, without putting taxpayers at risk and without removing resources from county budget.
"Guns are not the leading cause of death in this country—opioids are," said Attorney Robert Eglet. "We have seen first-hand how this epidemic has affected our family, neighbors, and communities."
According to a 2017 report from the Nevada Substance Abuse Working Group, the number of prescribed drugs increased; there are 94 painkiller prescriptions for every 100 Nevada residents, and 1 in 5 high school students reported they used a prescription drug not specifically written for them.
So far, the firm persuaded Clark and Washoe counties to hire them.
The firm is touring rural counties such as Carson City, Douglas, Humbolt, Lyon, and Nye as governments from Reno and Las Vegas recommended the firm to get small Nevada towns involved.
"Reno Mayor Hillary Schieve requested we represent every county and city in the state, regardless of size," Eglet said. "We're serving that with our duty."
Eglet Prince has handled civil litigation against pharmaceuticals and healthcare industries including Health Plan Nevada, sued for faulty credential policies after causing the largest, medically cause Hepatitis C outbreak in Clark County —and in history.
With over 350 lawsuits in court nationwide, there are over 800 opioid distributors with three of them making up 85 percent of the market, Eglet said.
Churchill County commissioners liked the idea but also were concerned if the county could provide data of local opioid use to benefit the firm's research.
While the Public Health Board in Churchill County is determining health concerns in the county, opioids are not a top concern said Commissioner Bus Scharmann.
"I don't want to say we don't have an opioid problem in Churchill County but we're not sure if we have the data you need, as far as the negative effects in our county," Scharmann said. "Our local problem is methamphetamine and we have local agencies looking into it."
Since 2000, meth use in Churchill County increased 75 percent.
But Eglet argued 80 percent of people in Churchill County are addicted to heroin because of prescription opioids.
"This isn't for people who are just addicted to heroin," he said. "You're going to see a spike in heroin addiction in your county and statewide because the legislature passed a legislation to make it difficult to get an opioid prescriptions."
Eglet explained people could purchase heroin from the streets, which contain the same ingredients and also costs less than the prescription itself.
Eglet said Nye County has a opioid prescription rate of 155—that's more than one prescription per person. He also said 90 percent of Humbolt County's cases circulate around opioids.
Eglet said each county in Nevada should bring its own case as there's a more favorable forum, public policy, and control over litigation.
Nevada also has not adopted the Learned Intermediary Doctrine, which allows drug companies to blame doctors.
Carson City and Lyon County are scheduled to make a decision to join the lawsuit at the next city meetings. Nye County is expected to approve an agreement in April and Humbolt County is considering the process, along with Churchill.
"We think these counties could get these cases in faster compared to Washoe and Clark," Eglet said. "But there's the potential of the case ending up in Federal Court or getting lost in the shuffle, and receiving a smaller share of the recovery."
Eglet is referring the time when former Nevada Attorney General Frankie Sue Del Papa signed the Master Settlement Agreement with four large tobacco companies, along with 46 states. Although the settlement was $206 billion over 25 years, Nevada only received $1.2 billion.
Attorney General Adam Laxalt has said filing these lawsuits could be a risk for Nevada; his opioid task force meeting held earlier this month focused on how responders and hospitals should obtain current information on opioid hot spots, spikes in overdoses, and deaths instead, in order to decrease the number of cases.
The opioid epidemic already has placed a financial burden on every Nevada city and county, such as increased costs for first responders and nalaxone kits in rural counties, Eglet said.
Although the Nevada Department of Health and Human Services reported state opioid-related deaths have dropped in 2016, hospitalizations and prescription rates continued to rise.
Nevada Rural Opioid Overdose Reversal also used a grant from the Federal Office of Rural Health Policy to train 117 EMTs for overdose calls in 2017; drug overdose deaths in Nevada increased 8 percent since 1999 ranking Nevada as the 4th highest state in drug overdose mortality rate in the country.
"In our communities, opioid drug companies continue to misrepresent the risks of long-term opioid use," Eglet said. "Their misrepresentations have been confirmed by the FDA and CDC, and have not corrected or changed it."
If Churchill County goes forward with the firm, the firm will then create retainer agreements and write the case on behalf of the county.
Eglet said it would be filed within the next couple of months and ready to present by 2019.
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Opioid lawsuit could harm community investment, GOP leaders say
Mar 28, 2018 | Michigan Live (MI)
By Malachi Barrett
Next week, Kalamazoo County leaders will discuss joining Michigan cities and counties in a lawsuit against some of the largest drug makers and pharmacies in the world.
County Board Vice Chair Dale Shugars and Commissioner Scott McGraw, both Republicans, publicly warned against joining the lawsuit at a Tuesday, March 27 Portage City Council meeting. Both asked Portage leaders and residents to attend a county discussion scheduled for 4 p.m. April 3 at 201 W. Kalamazoo Ave. in Kalamazoo.
On Dec. 19, 2017, yhe Sam Bernstein Law Firm and Weitz & Luxemberg filed federal civil lawsuits on behalf of nine Michigan cities and counties. It seeks to ask the court to force companies to award damages for opioid-related deaths, treatment and law enforcement costs.
Attorney Mark Bernstein distributed information on the lawsuit to the Kalamazoo County Board of Commissioners before it was filed last December. Shugars said Bernstein indicated the county could be reimbursed "a few hundred thousand dollars" if successful.
Dozens of Michigan communities since joined the lawsuit against a number of companies, while similar lawsuits are filed by cities across the United States.
Some of the largest companies named in the lawsuit include Purdue Pharma, the manufacturer of Oxycontin, several other drug makers, and large pharmacies, including CVS, Walgreens, Rite Aid and Costco.
The 156-page lawsuit alleges these and other companies knew drugs they manufactured and sold had the potential to be abused, but acted with reckless indifference.
"Defendants acted with a conscious disregard for the rights and safety of others in a manner that had a great probability of causing substantial harm," the lawsuit reads.
McGraw and Shugars worried about the impact the lawsuit could have on Portage's relationships with the pharmaceutical industry. At the same meeting, Portage officials applauded a planned $465 million expansion of Pfizer Inc. manufacturing campus -- which doesn't include opioid production.
"I think the local area has enough connections and support of the pharmaceutical industry; I hope an action like (the lawsuit) would not affect investment in this community and this county," McGraw said.
Shugars indicated that support for joining the litigation would be split 6-5 among party lines, but said the issue is best left for the U.S. Department of Justice or Congress.
Blame could be extended to doctors who write prescriptions or hospitals, he said, and Shugars warmed of a "slippery slope" that could muddy where responsibility lies.
He said county officials are concerned about the opioid epidemic, but getting involved in a lawsuit might not be the best course of action.
From 2015-16, the number of accidental drug-related deaths in Kalamazoo County more than doubled, from 33 to 72. Opioid-related deaths also doubled, from 29 to 59.
In the first half of 2017, there were 26 accidental opioid-related deaths.
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Humboldt County moves to sue Big Pharma; pot tax changes, interim chief probation officer OK’d
Mar 28, 2018 | Eureka Times Standard (CA)
By Will Houston
The Humboldt County Board of Supervisors gave the OK on Tuesday to hire a Seattle-based law firm to join in litigation claiming pharmaceutical companies and distributors misled the public on the addictive nature of opioid medication.
County Counsel Jeffrey Blanck said the ultimate goal of the lawsuit will be to recover costs the county has incurred for treating local opioid addiction as well as costs needed to address the issue into the future.
“We’re saying that manufacturers knew this, that if you didn’t take [patients with chronic pain] off [opioid medications] then they could get addicted,” Blanck said to the board. “And that’s the big issue is they precluded other types of treatment.”
Local law enforcement officials said opioids have had a significant impact on overdoses and an increase in heroin trafficking. Sheriff William Honsal said he fully supports the litigation.
“We see opioids have a huge impact here in Humboldt County,” Honsal told the board. “... We have this huge source of heroin coming in everyday, so we are on the front lines here.”
BIG PHARMA LAWSUIT
The board voted unanimously Tuesday to retain the Seattle-based Keller Rohrback law firm, which is already handling several other lawsuits being filed against pharmaceutical companies alleging that they misled the public and contributed to the opiate crisis, according to Blanck.
Blanck said that more than 300 lawsuits have been filed against pharmaceutical companies, including one by the Yurok Tribe earlier this month, many of which have been consolidated in a U.S. District Court for the Northern District of Ohio.
Restrictions on opioid medication prescriptions is believed by local law enforcement to have led to what they say is a “heroin epidemic” in the county. Sheriff’s office Drug Task Force Commander Lt. Bryan Quenell said that they have already seized 6 pounds of heroin in the first three months of this year, almost overtaking the 6.2 pounds seized in the entirety of 2017 and nearly three more than the 2.3 pounds seized in 2016.
“The overwhelming people that I speak to that are addicted to heroin started on some form of prescription medication,” Quenell said. “... Heroin is easier to get now than those prescription narcotics.”
According to a 2017 California Department of Public Health report, Humboldt County had the state’s second highest opioid overdose rate in 2016, at 22.35 per 100,000 residents — five times the state’s average rate that year.
The report also found there were more opioid prescriptions than there were county residents, with 156,444 prescriptions in 2016 or about 1,145 prescriptions per 1,000 residents.
County Chief Deputy Coroner Lt. Ernie Stewart said the county also has a significant methamphetamine overdose problem. He said that the county has a lack of addiction rehabilitation services, with the wait list for some programs being as long as 6 months to a year.
“During that time, there are a lot of people that are dying that could have been saved if they had gotten to those services sooner,” Stewart said.
County Chief Probation Officer William Damiano said wait times for rehabilitation programs depends on the program, with individuals who are subsidized by the county generally having shorter wait times than those who have private pay.
“We have limited capacity in our programs, and as I said earlier, there are a number of kinds of treatment for opioid dependence, some of which we don’t have in Humboldt County,” Damiano said, adding that there are also three local residential treatment programs and outpatient programs. “... We have some options here. We could always use more options.”
The county will hire the Keller Rohrback law firm on contingency, meaning that the county will not pay anything even if they lose. Blanck said that should the county win, the law firm will receive 20 percent of the damages the county is awarded if they are $20 million or below. If the damages are higher, the law firm will receive 25 percent, according to Blanck.
Cannabis tax changes
Earlier in the meeting, the board voted unanimously to alter the county’s cannabis cultivation tax. The board advanced an ordinance that would make several changes to its cannabis cultivation tax in an attempt to address concerns raised by cannabis farmers.
The changes include reducing the fees and penalties to growers who don’t pay their tax on time from an additional 25 percent of the total amount due to 10 percent, which mirrors the county’s penalty for delinquent property taxes. The board also approved allowing the county Treasurer-Tax Collector to waive or cancel any penalties, costs or other charges resulting from late tax payments if the taxpayer was unable to make the payment on time “due to circumstances beyond [their] control.”
The board also directed staff to allow for tax refunds if a farmer can prove that they did not farm that year or could not farm because of regulatory reasons.
“They’re going to have to prove it,” 2nd District Supervisors Estelle Fennell said. “There’s no doubt about that.”
Planning and Building Department director John Ford outlined some cases where the county’s rules did result in people not being able to grow, such as a person being permitted to grow, but being unable to cultivate without illegally diverting water.
An ordinance that would expand the local industry set to go before the board April 10 also includes a provision that allows a person to reduce their permitted cultivation area as long as they inform the county. The county’s cultivation tax is based on the square footage of permitted cultivation, not on the amount of cannabis actually produced.
The board is set to vote to make a final approval of the tax ordinance April 3.
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Mar 28, 2018 | Nashville, TN
By WZTV (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33891062?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: a program in colorado testing ways to treat pain without using opioid drugs, and so far it's proving to be pretty effective. researchers hope to see a 15% drop in little number ever opioids described in emergency rooms. instead, they saw a 36% decline. medication is taken to the area in pain instead of sending narcotics through the flood bloodstream. doctors say increased communication has also helped. >> i think the communication piece that we've done in the community, seen on the news has really gotten out there and let the people know that we do have alternatives and to not be afraid to come in. >> a.j.: this is the country's first large scale opioid research effort focused on emergency departments and it doesn't cost very much either. >> elisabeth: montgomery county filed a lawsuit against multiple pharmaceutical companies that motorcycle and distribute opioids. the purpose of the lawsuit is to eliminate the hazard of public health and safety caused by the opioid epidemic. the suits as countries push high lay dicktive drugs and represent them to doctors and patients. >>> and thre of six men arrested in connection to an overdose outbreak in nashville have now been convicted. the u.s. attorney's office saying the investigation began in july of 2016. one person died and 20 more were hospitalized. in each case, police found pills that looked exactly like percocet, but were actually counterfeit, containg fentanyl.
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Mar 27, 2018 | Nashville, TN
By WKRN (ABC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891104?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: new tonight-- montgomery county is now suing several pharmaceutical companies- claiming they are responsible for the opioid epidemic. the federal lawsuit says these companies "aggresively advertised" and persuaded doctors to prescribe opioids to patients. the lawsuit also says the opioid crisis has put a financial burden on the county. the suit asks for money to pay for medical care, treatment, and law enforcement. more than a dozen companies are named in the lawsuit. hayley: news two is committed to looking into ways people are fighting tennessee's opioid crisis...
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Mar 28, 2018 | Portland, OR
By KPTV (Fox)
Video Link: http://app.criticalmention.com/app/#clip/view/33891072?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: making sure the that we trea this as a public health crisis and continue on that path in direct contrast what is happening at the federal level. governor kate brown signed 2 ne bill substance abuse prevention nonprofit lines for life yesterday. the new legislation aimed at fighting the would be a lead-th opioid crisis development of concrete addiction plan by 2020 as well as focusing on measures to combat opioid problem. governor brown said these new laws just the first step in a long road to transform oregon into a recovery stage as clark county signing on to massive lawsuit against the pharmaceutical industry pic of the county joining 400 jurisdictions nationwide's taking drug manufacturers and wholesalers to federal court bu the lawsuit said partially to blame for widespread opioid addiction by knowingly giving false information to doctors an patients regarding opioidprescription safety. clark county and others looking to recover the public cost ten opioid abuse has drained from the community.
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Mar 28, 2018 | Albany, GA
By WALB (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891080?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: the opioid crisis is taking many neighborhoods and cities across the country by storm. and our leaders here in dougherty county are preparing to fight this epidemic. county commission chairman, chris cohilas, says commissioners plan to file a lawsuit against the pharmaceutical industry and pill abusers. walb news 10's ashley bohle is live in the newsroom with the latest. karla/cade, county commissioners are considering which law firm they could potentially choose to help ask for damages for dougherty county. according to the department of health and human services, in 20-16, one hundred 16 people died every day across the u.s. from opioid related drug overdoses. now on monday, five different law firms from across the state presented their experience and knowledge to the dougherty county commissioners. county attorney spencer lee says any of the five law firms would serve the community well. the litigation will take somewhere between two to three years. so we're way down the line on whether or not the county can show the damages to this community as a result of opioid abuse.
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Mar 28, 2018 | Charleston, WV
By WSAZ (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891086?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: the city has filed a lawsuit against opioid manufacturers and distributors.. companies they claim have flooded the market with pills, contributing to the drug cris nationwide. logan joins other municipalities, counties and states all across the country. logan's mayor says they want to do everyting to fight against "this poision that is in our area and many others." the lawsuit seeks damages to remedy the impact of the opioid crisis on the city.
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Mar 28, 2018 | Baltimore, MD
By WJZ (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33891089?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: hagerstown claims the pharmaceutical companies failed to check on suspicious orders, and the drugs are being overprescribed. >> the cdc's statistics on western maryland are that for every one person walking the street, that person has at least one opioid prescription. >>reporter: only a handful of maryland cities and counties have filed lawsuits like this, but the crisis could get worse still. >> i don't think we've peaked yet and that's the terrifying part in it. >>reporter: it could be 30-45 days until this lawsuit is officially filed. attorneys say they're handling all of the expenses to this case and will only be paid if they win.
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Mar 28, 2018 | Grand Rapids, MI
By WWMT (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33891092?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: the kalamazoo county commission is taking up a proposal to take part in a class action lawsuit in michigan against opioids.at last night's portage city council meeting, two members of the kalamazoo county commission announced there would be a county-wide discussion next week.there are about 50 cities and counties across michigan suiing to hold pharmaceutical companies, distributors and pharmacies accountable for the growing opioidepidemic.if
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Mar 28, 2018 | Eureka, CA
By KIEM (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33891095?token=468a010d-c0a7-4369-a01a-17308ce8fc0b
Rough Transcript: since january the humboldt county sheriff's office has seized more than 6 pounds of heroin... and in 20-17, 49 people died from an overdose. deputies say, most heroin addiction begins with prescription opioids... sticking with the numbers, nearly 156-thousand prescriptions for opiods are written ((take vo)) by doctors in the area - according to statistics delivered by county attorney jeffery blank. he helped advise humboldt supervisors to fight back... joing legal action against the major pharmaceutical companies that started pushing opioids as treatment for chronic pain, without fulling disclosing their addictive nature. (take sot) áno verbatimá out: ".. of fightin back." (take tag) the county will retain keller ror-back l.p., to launch into that litigation.. this will come at no cost to tax payers... and council will only be paid 25% of the take if the case is won.
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