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Opioid Litigation Daily Media Report - 4/3/18
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Justice Department seeks role in opioid settlement talks
Apr 2, 2018 | Reuters
By Nate Raymond
The U.S. Justice Department on Monday sought court permission to participate in settlement negotiations aimed at resolving lawsuits by state and local governments against opioid manufacturers and distributors. -
Justice Dept. says it will seek to join settlement talks in opioid lawsuits
Apr 2, 2018 | Associated Press
By Staff
The U.S. Department of Justice wants to join settlement talks in federal court involving hundreds of lawsuits against manufacturers and distributors of opioid painkillers. -
Justice Department wants to help with settlement talks in opioid litigation
Apr 3, 2018 | Cleveland.com (OH)
By Eric Heisig
The U.S. Justice Department on Monday asked a Cleveland federal judge to allow it to participate in settlement talks between local and state governments and drug companies embroiled in litigation over the nation's opioid crisis. -
Justice Department seeks to join opioid settlement talks
Apr 2, 2018 | Washington Times
By Jeff Mordock
The U.S. Department of Justice said Monday it wants to participate in settlement talks in a federal court case involving hundreds of lawsuits against opioid manufacturers and distributors. -
Opioid Litigation's Growing Strength: From Snowflakes To Blizzard
Apr 2, 2018 | The Pink Sheet
By Brenda Sandburg
Eleven years after Purdue Pharma LP pled guilty to marketing OxyContin as less addictive than other pain medicines the legal fallout has only intensified. Manufacturers and distributors are facing an ever-growing barrage of lawsuits and government prosecutors have launched new investigations of their sales and marketing practices. The expected settlements will not just have a financial impact on the firms involved, but may also set a precedent for what public health responsibilities companies are expected to bear. -
How Advertising Shaped the First Opioid Epidemic (Opinion)
Apr 3, 2018 | Smithsonian
By Jon Kelvey
When historians trace back the roots of today’s opioid epidemic, they often find themselves returning to the wave of addiction that swept the U.S. in the late 19th century. That was when physicians first got their hands on morphine: a truly effective treatment for pain, delivered first by tablet and then by the newly invented hypodermic syringe. With no criminal regulations on morphine, opium or heroin, many of these drugs became the “secret ingredient” in readily available, dubiously effective medicines. -
Jeff Sessions, Donald Trump say 'tough it out' without opioids but they never felt my pain (Opinion)
Apr 2, 2018 | USA Today
By Steven Horwitz
President Trump’s new proposal to combat opioid addiction included some very tough talk about a tragic problem, so it was easy to miss one ambitious goal: slashing legal opioid prescriptions by one-third. -
Tobacco lawsuits from the past may signal future in fight against opioids (Opinion)
Apr 2, 2018 | THV11 (AR)
By Rolly Hoyt
Last century, the vilified names were Philip Morris, Lorillard and Reynolds. Today, it's Janssen, Endo and other drug makers as lawyers and lawmakers pin the blame on Big Pharma the same way they brought down Big Tobacco 20 years ago. -
A closer look at New York tax on opioid manufacturers
Apr 2, 2018 | WBNG (NY)
By Monika Hammer
We're learning more about a new tax from the New York State budget. -
DEA’s opioid crackdown brings arrests of prescribers, pharmacists
Apr 2, 2018 | Washington Post
By Lenny Bernstein
The Drug Enforcement Administration arrested 28 drug prescribers and pharmacists, and revoked the licenses of 147 people who handle controlled substances, as part of a nationwide crackdown on the illegal use and distribution of opioids and other prescription medications, the Justice Department announced Monday. -
Marijuana legalization could help offset opioid epidemic, studies find
Apr 2, 2018 | CNN
By Mark Lieber
Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy. -
White House is urged to sidestep patents on opioid overdose treatment
Apr 2, 2018 | STAT News
By Ed Silverman
The White House is being urged to sidestep patents on a high-priced opioid overdose antidote as one way to stem the rising cost of combating the opioid crisis. -
Opioid lawsuit to take center stage at Kalamazoo County Commission meeting Tuesday
Apr 3, 2018 | WWMT (MI)
By Jake Berent
The opioid crisis will be the focus of Tuesday night's Kalamazoo County Commission meeting. -
North Royalton joins litigation over opioid epidemic
Apr 2, 2018 | Cleveland.com (OH)
By Bob Sandrick
North Royalton is the latest city to join litigation against drug manufacturers and distributors over the nation's opioid epidemic. The city joins dozens of governmental agencies in several states, including a number of other Northeast Ohio communities. -
County debates joining lawsuit against opioid manufacturers
Apr 3, 2018 | CJOnline (KS)
By John Green
Though not convinced drug manufacturers are to blame for opioid abuse in Reno County, the Reno County Commission on Tuesday will consider joining a multi-state lawsuit against those manufacturers to recover costs of responding to the epidemic. -
New legal tool could be used in the opioid epidemic battle
Apr 2, 2018 | WLOX (MS)
By Doug Walker
A new tool is being considered in the continuing battle against the opioid epidemic sweeping the country and the coast. That tool is the lawsuit. Harrison County supervisors voted Monday to consider filing litigation against the makers of narcotic painkillers and those who prescribe them. -
Montgomery County suing opioid manufacturers and distributors
Apr 3, 2018 | WSFA (AL)
By Staff
Montgomery County is the latest local government to file suit against prescription drug manufacturers and distributors. -
Chatham Co. sues opioid manufacturers, distributors
Apr 2, 2018 | WTOC (GA)
By Zach Logan
Chatham County is currently in the discovery period as it works to try and be reimbursed for the money spent dealing with the opioid crisis. -
Rhode Island hires Motley Rice for potential opioid litigation
Apr 2, 2018 | Reuters
By Nate Raymond
Rhode Island’s attorney general has hired a law firm to represent the state in potential litigation against opioid manufacturers and distributors. -
Towns Consider Joining Federal Suit in Opioid Epidemic
Apr 2, 2018 | Vineyard Gazette (MA)
By Holly Pretsky
Island towns are considering joining multi-district litigation to fight prescription opioid manufacturers and distributors. -
Northern Arapaho Tribe Sues Drug Companies Over Opioid Epidemic
Apr 3, 2018 | K2 Radio
By STaff
The Northern Arapaho Tribe has sued six pharmaceutical companies and three drug distributors that do business in Wyoming for the harm done to tribal members by the opioid crisis, according to a lawsuit filed in federal court on Monday. -
Carson City Board of Supervisors to consider joining lawsuit on opioids
Apr 2, 2018 | Nevada Appeal (NV)
By Anne Knowles
The Board of Supervisors on Thursday will consider whether to join a lawsuit against opioid manufacturers and distributors. -
CBS 8 News This Morning
Apr 3, 2018 | Montgomery, AL
By WAKA (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33987910?token=6f7f5db3-498e-486f-8f70-76216e6ac0db -
WRAL Morning News
Apr 3, 2018 | Raleigh-Durham, NC
By WRAL (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33987957?token=6f7f5db3-498e-486f-8f70-76216e6ac0db -
69 News Sunrise - 7:30am
Apr 3, 2018 | Philadelphia, PA
By WFMZ (WFMZ)
Video Link: http://app.criticalmention.com/app/#clip/view/33987953?token=6f7f5db3-498e-486f-8f70-76216e6ac0db -
WMC Action News AM at 6AM
Apr 3, 2018 | WMC (NBC)
By WMC (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33987974?token=6f7f5db3-498e-486f-8f70-76216e6ac0db -
KSL 5 News Today
Apr 3, 2018 | Salt Lake City, UT
By KSL (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33988028?token=6f7f5db3-498e-486f-8f70-76216e6ac0db -
WTOC THE News at Daybreak 7A
Apr 3, 2018 | Savannah, GA
By WTOC (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33988037?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
DOJ
Commentary and FYIs
Midwest (MI, OH, KS)
Southeast (MS, AL, GA)
Northeast (RI, MA)
West (WY)
Southwest (NV)
Broadcast Media Coverage
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Justice Department seeks role in opioid settlement talks
Apr 2, 2018 | Reuters
By Nate Raymond
The U.S. Justice Department on Monday sought court permission to participate in settlement negotiations aimed at resolving lawsuits by state and local governments against opioid manufacturers and distributors.
The Justice Department said in a brief it wanted to participate in talks overseen by a federal judge in Cleveland as a “friend of the court” that would provide information to help craft non-monetary remedies to combat the opioid crisis.
“We are determined to see that justice is done in this case and that ultimately we end this nation’s unprecedented drug crisis,” U.S. Attorney General Jeff Sessions said in a statement.
Last month, the Justice Department asked U.S. District Judge Dan Polster for 30 days to decide whether to participate in the litigation given the costs the federal government had incurred because of the opioid epidemic.
According to the U.S. Centers for Disease Control and Prevention, opioids were involved in over 42,000 overdose deaths in 2016. U.S. President Donald Trump has called for litigation against companies over their roles in the opioid epidemic.
But Monday’s brief signaled that the Justice Department would not be seeking to participate as an active litigant in the litigation before Polster, who is overseeing at least 433 opioid-related lawsuits brought primarily by cities and counties.
The lawsuits generally accuse drugmakers of deceptively marketing opioids and allege distributors ignored red flags indicating the painkillers were being diverted for improper uses. The defendants have denied wrongdoing.
Polster has been pushing for a global settlement and has invited state attorneys general who have cases and probes not before him to participate in the negotiations.
The defendants include drugmakers Purdue Pharma LP, Johnson & Johnson, Teva Pharmaceutical Industries Ltd, Endo International PLC and Allergan PLC and distributors AmerisourceBergen Corp, Cardinal Health Inc and McKesson Corp.
In Monday’s brief, the Justice Department said that while it was pursuing opioid-related criminal and civil cases, it would not be proper to consolidate them with the lawsuits before Polster.
Nevertheless, it said the federal government could provide information to assist in crafting a settlement.
The Justice Department noted the U.S. Drug Enforcement Administration had already agreed to produce data on the names and market shares of opioid manufacturers and distributors in each state.
The department said it also had an interest in facilitating discussions about the parties’ “legal obligations” given the federal government’s own substantial financial stake in fighting the epidemic.
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Justice Dept. says it will seek to join settlement talks in opioid lawsuits
Apr 2, 2018 | Associated Press
By Staff
The U.S. Department of Justice wants to join settlement talks in federal court involving hundreds of lawsuits against manufacturers and distributors of opioid painkillers.
The government says it can provide information and expertise to parties in the case and facilitate requests to government agencies including the Drug Enforcement Administration and the Food and Drug Administration.
The government made a request to join as a “friend of the court” in a filing before U.S. District Judge Dan Polster in Cleveland on Monday.
U.S. Attorney General Jeff Sessions says the government is determined to see justice done and the nation’s “unprecedented drug crisis” ended.
More than 400 cities and counties across the country have sued drug makers and distributors for costs associated with the addiction crisis.
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Justice Department wants to help with settlement talks in opioid litigation
Apr 3, 2018 | Cleveland.com (OH)
By Eric Heisig
The U.S. Justice Department on Monday asked a Cleveland federal judge to allow it to participate in settlement talks between local and state governments and drug companies embroiled in litigation over the nation's opioid crisis.
However, the Justice Department is not looking to fully participate as a party and throw its weight behind the plaintiffs in hundreds of lawsuits.
Rather, the federal government is only proposing to play a role as a so-called "friend of the court," asking that it be allowed in the room while settlement talks occur. It also wants an opportunity to provide information on the nation's opioid scourge and how any potential settlement could be crafted to combat the growing number of overdoses in the U.S.
"Though the United States' multiple opioids efforts pursuant to federal statutes are not proper to consolidate with the actions in this multidistrict litigation, the United States has expertise and information that can assist the parties in crafting a settlement that will effectively combat the opioid crisis on a nationwide basis," Assistant U.S. Attorney James Bennett wrote.
The motion says the government can help provide any information the judge and parties may request, such as the state-specific prescription pill data it has begun to release to the parties as part of the litigation.
The Justice Department is asking U.S. District Judge Dan Polster's approval to participate.
Polster is presiding over hundreds of lawsuits filed by local governments across the country, including Cleveland, Cuyahoga County and many other governments in the state.
The lawsuits say drug manufacturers like Purdue Pharma and Johnson & Johnson overstated the benefits and downplayed the risks of addiction when marketing opioids to treat pain, and that distributors failed to properly monitor suspicious orders of prescription painkillers.
The judge has pushed for a global settlement that would address all the lawsuits filed nationwide, including those not in his courtroom, and said the goal is to put money toward reducing the number of pills on the street.
Settlement talks are continuing, with another round set for next month.
U.S. Attorney General Jeff Sessions announced in February that the Justice Department would file a "statement of interest" in the opioid litigation, which many interpreted as a step toward going after the drug companies to recoup the costs borne by the federal government as a result of widespread painkiller addiction.
But its statement of interest, filed March 1, instead showed the Justice Department waffling on whether to intervene and asking for more time to decide on how to participate. It noted that the Justice Department has taken steps to combat the problem.
In the end, the Justice Department appears to have decided that an advisory role is best.
It says the government's request to participate in settlement talks "is consistent with the legal avenues ... that provide the United States with numerous ways in which to seek reimbursement for its direct and indirect costs of providing medical care to opioid users.
"The United States' substantial financial stake in combating the opioid epidemic has implications for the proper allocation of any monetary settlement of the claims asserted in the multi-district litigation," the statement says.
The limited route the Justice Department and Sessions decided to take appears at odds with the forceful step demanded by President Donald Trump. On Feb. 27, the same day the Justice Department filed a statement of interest, the president indicated that he spoke to Sessions about suing drug companies.
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Justice Department seeks to join opioid settlement talks
Apr 2, 2018 | Washington Times
By Jeff Mordock
The U.S. Department of Justice said Monday it wants to participate in settlement talks in a federal court case involving hundreds of lawsuits against opioid manufacturers and distributors.
On Monday, the Justice Department filed a “friend of the court” motion in the litigation before a Cleveland federal judge. A “friend of the court” is not direct party to the case, but provides information and expertise.
“We are formally seeking to provide the federal government’s expertise and legal counsel to the court on a potential settlement,” said Attorney General Jeff Sessions. “We are determined to see justice is done in this case and that ultimately we end this nation’s unprecedented drug crisis.”
If participation is granted by the court, the Justice Department will seek to advise the court on the national consequences of a settlement and any legal obligation of settling parties to reimburse the federal treasury.
The Justice Department has already filed a statement of interest in the case arguing that taxpayers should be reimbursed because of heavy cost of the opioid crisis to the U.S. Government. A report released last month estimated the opioid crisis has cost more than $1 trillion in health care and law enforcement expenses largely paid for by the federal government.
More than 400 cities and counties across the country have joined the lawsuit seeking reimbursement for costs associated with opioid addiction.
In February, Mr. Sessions announced the creation of a new task force to target the manufacturers and distributors of prescription painkillers. The Prescription Interdiction and Litigation, or PIL Task Force, will review all available criminal and civil penalties against opioid producers for any illegal activities. It will also examine puling the licenses of any pharmacist or physician who illegally prescribes opioids.
There were 64,000 fatal drug overdoes in the United States in 2016, the highest number ever recorded, according to the Justice Department. . Preliminary data indicates that 2017 will have even more overdose deaths. Most of the deaths are related to opioids, including prescription painkillers, illegal drugs such as heroin, and synthetic products such as fentanyl.
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Opioid Litigation's Growing Strength: From Snowflakes To Blizzard
Apr 2, 2018 | The Pink Sheet
By Brenda Sandburg
Eleven years after Purdue Pharma LP pled guilty to marketing OxyContin as less addictive than other pain medicines the legal fallout has only intensified. Manufacturers and distributors are facing an ever-growing barrage of lawsuits and government prosecutors have launched new investigations of their sales and marketing practices. The expected settlements will not just have a financial impact on the firms involved, but may also set a precedent for what public health responsibilities companies are expected to bear.
OxyContin (oxycodone controlled-release) was approved by FDA in December 1995 as the first formulation of oxycodone that allowed dosing every 12 hours instead of every four to six hours. In 2002, the US Department of Justice began investigating Purdue's promotion of the opioid, and in May 2007 the company pled guilty to misbranding the product with the intent to defraud or mislead, a felony under the Food, Drug and Cosmetic Act. Purdue agreed to pay $700m to DOJ and 49 states (the Commonwealth of Kentucky was the only state to opt out of the settlement) and three current and former executives pled guilty to a misbranding charge as responsible corporate officers.
Far from bringing the issue to rest, legal actions have only snowballed since the settlement. Numerous other branded long-acting opioid products came on the market after OxyContin and they, along with Purdue, were hit with the first lawsuits from states and counties in 2014.
Over the past year, as the opioid crisis has intensified, cities, counties, and Native American tribes have filed hundreds of suits against opioid manufacturers and distributers. And at least three recent suits, brought by counties in Texas and Virginia, have named pharmacy benefit managers as plaintiffs. (See timeline below.)
The complaints have been consolidated in multi-district litigation in the Northern District of Ohio for pre-trial proceedings. Judge Dan Polster, who is overseeing the litigation, is pushing the parties to reach a settlement, which is expected to require manufacturers to implement actions to get to the root of opioid addiction and abuse, as well as provide significant monetary compensation. (Also see "Opioid Litigation: Court Asks US FDA To Attend Education Session" - Pink Sheet, 30 Jan, 2018.)
To assist in settlement efforts, the court ordered and the DOJ authorized the Drug Enforcement Administration to disclose the identity of manufacturers and distributors who sold 95% of the opiates in each state from Jan. 1, 2006 through Dec. 31, 2014 – and provide an aggregate amount of pills sold and the market shares of each manufacturer and distributor on a state-by-state basis. The information is confidential and subject to a protective order.
The court has also directed the distributor defendants to share their techniques for identifying "suspicious orders" in order to develop recommendations for improved monitoring and/or reporting. In a March 27 order, the court rejected concerns raised by AmerisourceBergen Corp., Cardinal Health Inc. and McKesson Corp. that sharing proprietary and confidential information could violate antitrust laws.
The remainder of this article is under paywall here: https://pink.pharmaintelligence.informa.com/PS122825/Opioid-Litigations-Growing-Strength-From-Snowflakes-To-Blizzard
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How Advertising Shaped the First Opioid Epidemic (Opinion)
Apr 3, 2018 | Smithsonian
By Jon Kelvey
When historians trace back the roots of today’s opioid epidemic, they often find themselves returning to the wave of addiction that swept the U.S. in the late 19th century. That was when physicians first got their hands on morphine: a truly effective treatment for pain, delivered first by tablet and then by the newly invented hypodermic syringe. With no criminal regulations on morphine, opium or heroin, many of these drugs became the “secret ingredient” in readily available, dubiously effective medicines.
In the 19th century, after all, there was no Food and Drug Administration (FDA) to regulate the advertising claims of health products. In such a climate, a popular so-called “patent medicine” market flourished. Manufacturers of these nostrums often made misleading claims and kept their full ingredients list and formulas proprietary, though we now know they often contained cocaine, opium, morphine, alcohol and other intoxicants or toxins.
Products like heroin cough drops and cocaine-laced toothache medicine were sold openly and freely over the counter, using colorful advertisements that can be downright shocking to modern eyes. Take this 1885 print ad for Mrs. Winslow’s Soothing Syrup for Teething Children, for instance, showing a mother and her two children looking suspiciously beatific. The morphine content may have helped.
Yet while it’s easy to blame patent medicines and American negligence for the start of the first opioid epidemic, the real story is more complicated. First, it would be a mistake to assume that Victorian era Americans were just hunky dory with giving infants morphine syrup. The problem was, they just didn’t know. It took the work of muckraking journalists such as Samuel Hopkins Adams, whose exposé series, “The Great American Fraud” appeared in Colliers from 1905 to 1906, to pull back the curtain.
But more than that, widespread opiate use in Victorian America didn’t start with the patent medicines. It started with doctors.
The Origins of Addiction
Patent medicines typically contained relatively small quantities of morphine and other drugs, says David Herzberg, a professor of history at SUNY-University at Buffalo. “It’s pretty well recognized that none of those products produced any addiction,” says Herzberg, who is currently writing a history of legal narcotics in America.
Until the Harrison Narcotics Act of 1914, there were no federal laws regulating drugs such as morphine or cocaine. Moreover, even in those states that had regulations on the sale of narcotics beginning in the 1880s, Herzberg notes that “laws were not part of the criminal code, instead they were part of medical/pharmacy regulations.”
The laws that existed weren’t well-enforced. Unlike today, a person addicted to morphine could take the same “tattered old prescription” back to a compliant druggist again and again for a refill, says David Courtwright, a historian of drug use and policy at the University of North Florida.
And for certain ailments, patent medicines could be highly effective, he adds. “Quite apart from the placebo effect, a patent medicine might contain a drug like opium,” says Courtwright, whose book Dark Paradise: A History of Opiate Addiction in America, provides much of the original scholarship in this area. “If buyers took a spoonful because they had, say, a case of the runs, the medicine probably worked.” (After all, he points out, “opium is a constipating agent.”)
Patent medicines may not have been as safe as we would demand today or live up to claims of panacea, but when it came to coughs and diarrhea, they probably got the job done. “Those drugs are really famous, and they do speak to a time where markets were a little bit out of control,” Herzberg says. “But the vast majority of addiction during their heyday was caused by physicians.”
Marketing to Doctors
For 19th century physicians, cures were hard to come by. But beginning in 1805, they were handed a way to reliably make patients feel better. That’s the year German pharmacist Friedeich Serturner isolated morphine from opium, the first “opiate” (the term opioid once referred to purely synthetic morphine like drugs, Courtwright notes, before becoming a catchall covering even those drugs derived from opium).
Delivered by tablet, topically and, by mid-century, through the newly invented hypodermic syringe, opium quickly made itself indispensable. Widespread use by soliders during the Civil War also helped trigger the epidemic, as Erick Trickey reports in Smithsonian.com. By the 1870s, morphine became something of “a magic wand [doctors] could wave to make painful symptoms temporarily go away,” says Courtwright.
Doctors used morphine liberally to treat everything from the pain of war wounds to menstrual cramps. “It’s clear that that was the primary driver of the epidemic,” Courtwright says. And 19th century surveys Courtwright studied showed most opiate addicts to be female, white, middle-aged, and of “respectable social background”—in other words, precisely the kind of people who might seek out physicians with the latest tools.
Industry was quick to make sure physicians knew about the latest tools. Ads for morphine tablets ran in medical trade journals, Courtwright says, and, in a maneuver with echoes today, industry sales people distributed pamphlets to physicians. The College of Physicians of Philadelphia Historical Medical Library has a collection of such “medical trade ephemera” that includes a 1910 pamphlet from The Bayer Company titled, “The Substitute for the Opiates.”
The substitute? Heroin hydrochloride, at the time a new drug initially believed to be less addictive than morphine. Pamphlets from the Antikamnia Chemical Company, circa 1895 show an easy cheat sheet catalog of the company’s wares, from quinine tablets to codeine and heroin tablets.
Physicians and pharmacists were the key drivers in increasing America’s per capita consumption of drugs like morphine by threefold in the 1870s and 80s, Courthwright writes in a 2015 paper for the New England Journal of Medicine. But it was also physicians and pharmacists who ultimately helped bring the crisis back under control.
In 1889, Boston physician James Adams estimated that about 150,000 Americans were “medical addicts”: those addicted through morphine or some other prescribed opiate rather than through recreational use such as smoking opium. Physicians like Adams began encouraging their colleagues to prescribe “newer, non-opiate analgesics,” drugs that did not lead to depression, constipation and addiction.
“By 1900, doctors had been thoroughly warned and younger, more recently trained doctors were creating fewer addicts than those trained in the mid-nineteenth century,” writes Courtwright.
This was a conversation had between doctors, and between doctors and industry. Unlike today, drug makers did not market directly to the public and took pride in that contrast with the patent medicine manufacturers, Herzberg says. “They called themselves the ethical drug industry and they would only advertise to physicians.”
But that would begin to change in the early 20th century, driven in part by a backlash to the marketing efforts of the 19th century patent medicine peddlers.
Marketing to the Masses
In 1906, reporting like Adams’ helped drum up support for the Pure Food and Drug Act. That gave rise to what would become the Food and Drug Administration, as well as the notion that food and drug products should be labeled with their ingredients so consumers could make reasoned choices.
That idea shapes federal policy right up until today, says Jeremy Greene, a colleague of Herzberg’s and a professor of the history of medicine at Johns Hopkins University School of Medicine: “That path-dependent story is part of the reason why we are one of the only countries in the world that allows direct-to-consumer advertising,” he says.
At the same time, in the 1950s and 60s, pharmaceutical promotion became more creative, coevolving with the new regulatory landscape, according to Herzeberg. As regulators have set out the game, he says, “Pharma has regularly figured out how to play that game in ways that benefit them.
Though the tradition of eschewing direct marketing to the public continued, advertising in medical journals increased. So, too, did more unorthodox methods. Companies staged attention-grabbing gimmicks, such as Carter Products commissioning Salvador Dali to make a sculpture promoting its tranquilizer, Miltown, for a conference. Competitor Roche Pharmaceuticals invited reporters to watch as its tranquilizer Librium was used to sedate a wild lynx.
Alternatively, some began taking their messaging straight to the press.
“You would feed one of your friendly journalists the most outlandishly hyped-up promise of what your drug could do,” Greene says. “Then there is no peer review. There is no one checking to if see it’s true; it’s journalism!” In their article, Greene and Herzberg detail how ostensibly independent freelance science journalists were actually on the industry payroll, penning stories about new wonder drugs for popular magazines long before native advertising became a thing.
One prolific writer, Donald Cooley, wrote articles with headlines such as “Will Wonder Drugs Never Cease!” for magazines like Better Homes and Garden and Cosmopolitan. “Don’t confuse the new drugs with sedatives, sleeping pills, barbiturates or a cure,” Cooley wrote in an article titled “The New Nerve Pills and Your Health.” “Do realize they help the average person relax.”
As Herzberg and Greene documented in a 2010 article in the American Journal of Public Health, Cooley was actually one of a stable of writers commissioned by the Medical and Pharmaceutical Information Bureau, a public relations firm, working for the industry. In a discovery Herzberg plans to detail in an upcoming book, it turns out there is “a rich history of companies knocking at the door, trying to claim that new narcotics are in fact non-addictive” and running advertisements in medical trade journals that get swatted down by federal authorities.
A 1932 ad in the Montgomery Advertiser, for instance, teases a new “pain relieving drug, five times as potent as morphine, as harmless as water and with no habit forming qualities.” This compound, “di-hydro-mophinone-hydrochlorid” is better known by the brand name Dilauded, and is most definitely habit forming, according to Dr. Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at Johns Hopkins.
And while it’s not clear if the manufacturer truly believed it was harmless, Alexander says it illustrates the danger credulity presents when it comes to drug development. “If it sounds too good to be true, it probably is,” he says. “It is this sort of thinking, decades later, that has driven the epidemic.”
It wasn’t until 1995, when Purdue Pharma successfully introduced OxyContin, that one of these attempts was successful, says Herzberg. “OxyContin passed because it was claimed to be a new, less-addictive type of drug, but the substance itself had been swatted down repeatedly by authorities since the 1940s,” he says. OxyContin is simply oxycodone, developed in 1917, in a time-release formulation Purdue argued allowed a single dose to last 12 hours, mitigating the potential for addiction.
Ads targeting physicians bore the tagline, “Remember, effective relief just takes two.”
“If OxyContin had been proposed as a drug in 1957 authorities would have laughed and said no,” Herzberg says.
Captivating the Consumer
In 1997, the FDA changed its advertising guidelines to open the door to direct-to-consumer marketing of drugs by the pharmaceutical industry. There were a number of reasons for this reversal of more than a century of practice, Greene and Herzberg say, from the ongoing ripples of the Reagan-era wave of deregulation, to the advent of the “blockbuster” pharmaceutical, to advocacy by AIDS patients rights groups.
The consequences were profound: a surge of industry spending on print and television advertising describing non-opioid drugs to the public that hit a peak of $3.3 billion in 2006. And while ads for opioid drugs were typically not shown on television, Greene says the cultural and political shifts that made direct-to-consumer advertising possible also changed the reception to the persistent pushing of opioids by industry.
Once again, it was not the public, but physicians that were the targets of opioid marketing, and this was often quite aggressive. The advertising campaign for OxyContin, for instance, was in many ways unprecedented.
Purdue Pharma provided physicians with starter coupons that gave patients a free seven to 30-day supply of the drug . The company’s sales force—which more than doubled in size from 1996 to 2000—handed doctors OxyContin-branded swag including fishing hats and plush toys. A music CD was distributed with the title “Get in the Swing with OxyContin.” Prescriptions for OxyContin for non-cancer related pain boomed from 670,000 written in 1997, to 6.2 million in 2002.
But even this aggressive marketing campaign was in many ways just the smoke. The real fire, Alexander argues, was a behind-the-scenes effort to establish a more lax attitude toward prescribing opioid medications generally, one which made regulators and physicians alike more accepting of OxyContin.
“When I was in residency training, we were taught that one needn’t worry about the addictive potential of opioids if a patient had true pain,” he says. Physicians were cultivated to overestimate the effectiveness of opioids for treating chronic, non-cancer pain, while underestimating the risks, and Alexander argues this was no accident.
Purdue Pharma funded more than 20,000 educational programs designed to promote the use of opioids for chronic pain other than cancer, and provided financial support for groups such as the American Pain Society. That society, in turn, launched a campaign calling pain “the fifth vital sign,” which helped contribute to the perception there was a medical consensus that opioids were under, not over-prescribed.
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Are there lessons that can be drawn from all this? Herzberg thinks so, starting with the understanding that “gray area” marketing is more problematic than open advertising. People complain about direct-to-consumer advertising, but if there must be drug marketing, “I say keep those ads and get rid of all the rest,” he says, “because at least those ads have to tell the truth, at least so far as we can establish what that is.”
Even better, Herzberg says, would be to ban the marketing of controlled narcotics, stimulants and sedatives altogether. “This could be done administratively with existing drug laws, I believe, based on the DEA’s power to license the manufacturers of controlled substances.” The point, he says, would not be to restrict access to such medications for those who need them, but to subtract “an evangelical effort to expand their use.”
Another lesson from history, Courtwright says, is that physicians can be retrained. If physicians in the late 19th century learned to be judicious with morphine, physicians today can relearn that lesson with the wide array of opioids now available.
That won’t fix everything, he notes, especially given the vast black market that did not exist at the turn of the previous century, but it’s a proven start. As Courtwright puts it: Addiction is a highway with a lot of on-ramps, and prescription opioids are one of them. If we remove the billboards advertising the exit, maybe we can reduce, if not eliminate the number of travelers.
“That’s how things work in public health,” he says. “Reduction is the name of the game.”
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Jeff Sessions, Donald Trump say 'tough it out' without opioids but they never felt my pain (Opinion)
Apr 2, 2018 | USA Today
By Steven Horwitz
President Trump’s new proposal to combat opioid addiction included some very tough talk about a tragic problem, so it was easy to miss one ambitious goal: slashing legal opioid prescriptions by one-third.
Similarly, when Attorney General Jeff Sessions suggested that part of the problem is that not enough people are willing to “tough it out,” and that they should be just taking aspirin instead, he quickly got my attention. Recently, I tried to do just that.
In early November, at the age of 53, I spent a week in the hospital and was eventually diagnosed with multiple myeloma, a plasma cancer. Thankfully, there are a variety of treatments that hold the promise of long-term remission. But in the short term, multiple myeloma can be extraordinarily painful and many patients can only get relief by using prescription painkillers such as opioids.
Concerns over opioids are not unfounded. The CDC reports that overdoses from prescription opioids have quadrupled since 1999, numbering over 20,000 in 2015. Those numbers are of real concern, but we cannot forget that there are also real, tangible costs of living with pain — and that pain relief is part of the healing process for patients like me.
Multiple myeloma eats away at the calcium in your bones, weakening them. In my case, it went after my back, causing two small stress fractures and numerous lesions, all of which were extremely painful.
In the hospital, I was able to deal with that pain using Tylenol, mostly because I was just in a bed or chair all day. I declined the offer of prescription painkillers when I was discharged. One reason was that worries about opioid addiction had me concerned. Unfortunately, it didn’t take long for the pain to become serious once I got home and started moving more.
People who wish to drastically limit access to opioids need to know the reality of this kind of pain. Getting out of bed took 10 minutes or more because even one small wrong movement while getting to a sitting position would cause severe back spasms, making me shudder with pain. Walking around my house required balancing myself on walls and door frames.
The pain from sitting down and standing up from the toilet required that I use a chair to hold my weight like one would use a walker. I had visions of being found in the bathroom, stuck on the toilet or even unable to get up off of the floor. Every little twist and turn of my body risked those spasms and shuddering.
Eventually I realized my mistake and got a prescription for opioids. The quality of my life quickly and dramatically improved, as within two or three days, the pain was reduced substantially and my mobility and mood were significantly better. I could walk comfortably and hug my kids again.
It’s important to understand that this kind of debilitating pain not only causes unnecessary suffering, it prevents patients from healing. It takes every bit of energy you have to fight it, and your body has little to nothing left to use to heal. Some medical professionals call pain “the fifth vital sign” because of the way in which it matters for a patient’s health. Opioids enabled me to relax, to sleep and to heal.
Four months later, I am almost completely pain-free and have been largely able to resume most of my normal activities. Blood work indicates that my chemotherapy is beating back the cancer. Access to opioids has without a doubt been a key factor in how quickly my health has improved.
The controversy around opioids makes people fear legitimate and humane medication. I can’t get back that week I spent in pain. I can’t erase the experience of watching my kids and the rest of my family seeing me suffer.
Policymaking that ignores the benefits of opioids and focuses only on the drawbacks —as serious as they are — is unacceptably one-sided, and passing such policies will mean that thousands, if not millions, will suffer unnecessary pain and fail to heal as they should.
Tackling opioid overuse may indeed require a serious overhaul of a health care system in which some doctors find it easier to throw pills at patients than talk to them. And when those pills are paid for by third parties, the incentives to use them sparingly are weakened.
But in the end, what medications are appropriate will always best be determined within the doctor-patient relationship, not by bureaucratic dictates and bans. The opioid problem might be real, but unilaterally denying relief to those in pain is a cure that’s worse than the disease.
Steven Horwitz is an economist with Ball State University and an affiliated senior scholar with the Mercatus Center at George Mason University.
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Tobacco lawsuits from the past may signal future in fight against opioids (Opinion)
Apr 2, 2018 | THV11 (AR)
By Rolly Hoyt
Last century, the vilified names were Philip Morris, Lorillard and Reynolds. Today, it's Janssen, Endo and other drug makers as lawyers and lawmakers pin the blame on Big Pharma the same way they brought down Big Tobacco 20 years ago.
At two news conferences in the last month, the state and every county have announced lawsuits against companies for the way they marketed pain pills, leading to an addiction crisis.
“We're filing suit on behalf of the state of Arkansas against three opioid manufacturers,” said Attorney General Leslie Rutledge last week. “This is a lethal and tragic addiction that is destroying lives in our state.”
Rutledge’s office hired outside counsel to investigate how to go after the firms. She said there's evidence they lied to get doctors to write prescriptions and get millions hooked on pain pills.
Lies leading to addiction is a case that successfully took down another product in the late 1990s.
“We oversee, monitor and evaluate programs that are funded through the tobacco settlement dollars,” said Matt Gilmore, the director of the tiny Arkansas Tobacco Settlement Commission.
For 18 years, it's been this 9-person panel that has funneled millions of dollars coming back to Arkansas after Big Tobacco settled lawsuits over how it marketed cigarettes.
Smoking here is down thanks in part to those programs.
“They’re all focused on health,” Gilmore said. “Some are focused on research. Some are focused on certain health outcomes. Some are focused strictly on tobacco reduction.”
Plaintiffs like Rutledge have that template to follow, but don't expect an overnight change based on what Gilmore has seen over the years.
“It's a constant battle because the tobacco companies have a lot more money than we're given through the settlement,” he said. “We are seeing progress. We're constantly seeing a decrease. So that's a good thing.”
Two of the three drug makers in the attorney general's lawsuit say they plan to fight the allegations.
Local cities and counties have their own cases going against dozens more companies and they are among hundreds of cases across the country. Many of the tobacco cases consolidated ahead of the settlement 20 years ago.
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A closer look at New York tax on opioid manufacturers
Apr 2, 2018 | WBNG (NY)
By Monika Hammer
We're learning more about a new tax from the New York State budget.
The budget passed on Saturday contains a notable new tax, a fee on opioid manufacturers and distributors.
The money raised from this fee will go to combat addiction through already existing programs.
"Under this proposal, the finally agreed upon proposal, the stewardship program will generate 100 million dollars, and its somewhat problematic in terms of no new programming, that's where really I have my biggest hangup," State Senator Fred Akshar, a Republican who represents New York's 52nd District said.
While Senator Akshar has some reservations about this part of the budget, he says it is important to continue to fight the opioid epidemic.
"At the end of the day we have such a massive problem with the heroin and the opioid crisis, we are investing hundreds of millions of dollars to deal with that issue, the fact that now those who manufacture opiates, those who in my humble opinion are partially responsible for the problem that we currently have, should be in fact finding money toward finding a solution," Akshar added.
12 News also reached out to Assemblywoman Donna Lupardo, a Democrat who represents New York's 123rd district, to get her take on this part of the budget. She was not available Monday.
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DEA’s opioid crackdown brings arrests of prescribers, pharmacists
Apr 2, 2018 | Washington Post
By Lenny Bernstein
The Drug Enforcement Administration arrested 28 drug prescribers and pharmacists, and revoked the licenses of 147 people who handle controlled substances, as part of a nationwide crackdown on the illegal use and distribution of opioids and other prescription medications, the Justice Department announced Monday.
The 45-day enforcement “surge” stemmed from a review, ordered by Attorney General Jeff Sessions, of 80 million drug transactions. The review revealed dispensers who sold disproportionately large amounts of drugs, particularly opioid painkillers, and sparked 188 investigations.
“Our efforts are just getting started,” Sessions said in a news release. “ . . . DEA will surge task force officers and more analysts to places across America where the opioid crisis is at its worst.”
It did not appear that the effort targeted any of the drug distributors or manufacturers that have been blamed for allowing hundreds of millions of opioid painkillers to pour out of the legitimate supply chain into the black market over the past 15 years. Under federal law, wholesale distributors — the middlemen who move drugs from manufacturers to dispensers — are required to notify the DEA when they see unusual amounts, patterns or frequency of drug shipments.
The Washington Post and other media outlets have reported that some companies failed to do that, allowing the pills to find their way to users and dealers and propelling the epidemic that killed nearly 64,000 people in 2016, the most recent year for which overdose death statistics are available.
The Post also has reported that, at the height of the crisis, the DEA slowed its enforcement efforts and saw its work undermined by a law passed by Congress. The law took away the DEA’s most potent weapon against drug companies. The Justice Department and others have called for it to be amended.
In the recent drug crackdown, authorities said the DEA issued 283 administrative actions. Those included orders that force providers to surrender their controlled substance licenses (or “registrations”), that immediately prohibit the dispensing of narcotics, and that require recipients to show at a hearing why they should not be barred from providing the drugs.
A breakdown of those actions was not immediately available.
The DEA did not respond to questions seeking further detail.
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Marijuana legalization could help offset opioid epidemic, studies find
Apr 2, 2018 | CNN
By Mark Lieber
Experts have proposed using medical marijuana to help Americans struggling with opioid addiction. Now, two studies suggest that there is merit to that strategy.
The studies, published Monday in the journalJAMA Internal Medicine, compared opioid prescription patterns in states that have enacted medical cannabis laws with those that have not. One of the studies looked at opioid prescriptions covered by Medicare Part D between 2010 and 2015, while the other looked at opioid prescriptions covered by Medicaid between 2011 and 2016.
The researchers found that states that allow the use of cannabis for medical purposes had 2.21 million fewer daily doses of opioids prescribed per year under Medicare Part D, compared with those states without medical cannabis laws. Opioid prescriptions under Medicaid also dropped by 5.88% in states with medical cannabis laws compared with states without such laws, according to the studies.
"This study adds one more brick in the wall in the argument that cannabis clearly has medical applications," said David Bradford, professor of public administration and policy at the University of Georgia and a lead author of the Medicare study.
"And for pain patients in particular, our work adds to the argument that cannabis can be effective."
Medicare Part D, the optional prescription drug benefit plan for those enrolled in Medicare, covers more than 42 million Americans, including those 65 or older. Medicaid provides health coverage to more than 73 million low-income individuals in the US, according to the program's website.
"Medicare and Medicaid publishes this data, and we're free to use it, and anyone who's interested can download the data," Bradford said. "But that means that we don't know what's going on with the privately insured and the uninsured population, and for that, I'm afraid the data sets are proprietary and expensive."
'This crisis is very real'
The new research comes as the United States remains entangled in the worst opioid epidemic the world has ever seen. Opioid overdose has risen dramatically over the past 15 years and has been implicated in over 500,000 deaths since 2000 -- more than the number of Americans killed in World War II.
"As somebody who treats patients with opioid use disorders, this crisis is very real. These patients die every day, and it's quite shocking in many ways," said Dr. Kevin Hill, an addiction psychiatrist at Beth Israel Deaconess Medical Center and an assistant professor of psychiatry at Harvard Medical School, who was not involved in the new studies.
"We have had overuse of certain prescription opioids over the years, and it's certainly contributed to the opioid crisis that we're feeling," he added. "I don't think that's the only reason, but certainly, it was too easy at many points to get prescriptions for opioids."
Today, more than 90 Americans a day die from opioid overdose, resulting in more than 42,000 deaths per year, according to the US Centers for Disease Control and Prevention. Opioid overdose recently overtook vehicular accidents and shooting deaths as the most common cause of accidental death in the United States, the CDC says.
Like opioids, marijuana has been shown to be effective in treating chronic pain as well as other conditions such as seizures, multiple sclerosis and certain mental disorders, according to the National Institute on Drug Abuse. Research suggests that the cannabinoid and opioid receptor systems rely on common signaling pathways in the brain, including the dopamine reward system that is central to drug tolerance, dependence and addiction.
"All drugs of abuse operate using some shared pathways. For example, cannabinoid receptors and opioid receptors coincidentally happen to be located very close by in many places in the brain," Hill said. "So it stands to reason that a medication that affects one system might affect the other."
But unlike opioids, marijuana has little addiction potential, and virtually no deaths from marijuana overdose have been reported in the United States, according to Bradford.
"No one has ever died of cannabis, so it has many safety advantages over opiates," Bradford said. "And to the extent that we're trying to manage the opiate crisis, cannabis is a potential tool."
Comparing states with and without medical marijuana laws
In order to evaluate whether medical marijuana could function as an effective and safe alternative to opioids, the two teams of researchers looked at whether opioid prescriptions were lower in states that had active medical cannabis laws and whether those states that enacted these laws during the study period saw reductions in opioid prescriptions.
Both teams, in fact, did find that opioid prescriptions were significantly lower in states that had enacted medical cannabis laws. The team that looked at Medicaid patients also found that the four states that switched from medical use only to recreational use -- Alaska, Colorado, Oregon and Washington -- saw further reductions in opioid prescriptions, according to Hefei Wen, assistant professor of health management and policy at the University of Kentucky and a lead author on the Medicaid study.
"We saw a 9% or 10% reduction (in opioid prescriptions) in Colorado and Oregon," Wen said. "And in Alaska and Washington, the magnitude was a little bit smaller but still significant."
The first state in the United States to legalize marijuana for medicinal use was California, in 1996. Since then, 29 states and the District of Columbia have approved some form of legalized cannabis. All of these states include chronic pain -- either directly or indirectly -- in the list of approved medical conditions for marijuana use, according to Bradford.
The details of the medical cannabis laws were found to have a significant impact on opioid prescription patterns, the researchers found. States that permitted recreational use, for example, saw an additional 6.38% reduction in opioid prescriptions under Medicaid compared with those states that permitted marijuana only for medical use, according to Wen.
The method of procurement also had a significant impact on opioid prescription patterns. States that permitted medical dispensaries -- regulated shops that people can visit to purchase cannabis products -- had 3.742 million fewer opioid prescriptions filled per year under Medicare Part D, while those that allowed only home cultivation had 1.792 million fewer opioid prescriptions per year.
"We found that there was about a 14.5% reduction in any opiate use when dispensaries were turned on -- and that was statistically significant -- and about a 7% reduction in any opiate use when home cultivation only was turned on," Bradford said. "So dispensaries are much more powerful in terms of shifting people away from the use of opiates."
The impact of these laws also differed based on the class of opioid prescribed. Specifically, states with medical cannabis laws saw 20.7% fewer morphine prescriptions and 17.4% fewer hydrocodone prescriptions compared with states that did not have these laws, according to Bradford.
Fentanyl prescriptions under Medicare Part D also dropped by 8.5% in states that had enacted medical cannabis laws, though the difference was not statistically significant, Bradford said. Fentanyl is a synthetic opioid, like heroin, that can be prescribed legally by physicians. It is 50 to 100 times more potent than morphine, and even a small amount can be fatal, according to the National Institute on Drug Abuse.
"I know that many people, including the attorney general, Jeff Sessions, are skeptical of cannabis," Bradford said. "But, you know, the attorney general needs to be terrified of fentanyl."
'A call to action'
This is not the first time researchers have found a link between marijuana legalization and decreased opioid use. A 2014 study showed that states with medical cannabis laws had 24.8% fewer opioid overdose deaths between 1999 and 2010. A study in 2017 also found that the legalization of recreational marijuana in Colorado in 2012 reversed the state's upward trend in opioid-related deaths.
"There is a growing body of scientific literature suggesting that legal access to marijuana can reduce the use of opioids as well as opioid-related overdose deaths," said Melissa Moore, New York deputy state director for the Drug Policy Alliance. "In states with medical marijuana laws, we have already seen decreased admissions for opioid-related treatment and dramatically reduced rates of opioid overdoses."
Some skeptics, though, argue that marijuana legalization could actually worsen the opioid epidemic. Another 2017 study, for example, showed a positive association between illicit cannabis use and opioid use disorders in the United States. But there may be an important difference between illicit cannabis use and legalized cannabis use, according to Hill.
"As we have all of these states implementing these policies, it's imperative that we do more research," Hill said. "We need to study the effects of these policies, and we really haven't done it to the degree that we should."
The two recent studies looked only at patients enrolled in Medicaid and Medicare Part D, meaning the results may not be generalizable to the entire US population.
But both Hill and Moore agree that as more states debate the merits of legalizing marijuana in the coming months and years, more research will be needed to create consistency between cannabis science and cannabis policy.
"There is a great deal of movement in the Northeast, with New Hampshire and New Jersey being well-positioned to legalize adult use," Moore said. "I believe there are also ballot measures to legalize marijuana in Arizona, Florida, Missouri, Nebraska and South Dakota as well that voters will decide on in Fall 2018."
Hill called the new research "a call to action" and added, "we should be studying these policies. But unfortunately, the policies have far outpaced the science at this point."
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White House is urged to sidestep patents on opioid overdose treatment
Apr 2, 2018 | STAT News
By Ed Silverman
The White House is being urged to sidestep patents on a high-priced opioid overdose antidote as one way to stem the rising cost of combating the opioid crisis.
e White House is being urged to sidestep patents on a high-priced opioid overdose antidote as one way to stem the rising cost of combating the opioid crisis.
In a letter sent last Thursday, an advocacy group argues the White House should use a little-known federal law that would permit the government to take title to patents on Evzio. This is a decades-old version of naloxone, which is widely used to reverse the effect of opioid and heroin overdoses.
The remainder of this article is under paywall at: https://www.statnews.com/pharmalot/2018/04/02/white-house-opioids-patents/
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Opioid lawsuit to take center stage at Kalamazoo County Commission meeting Tuesday
Apr 3, 2018 | WWMT (MI)
By Jake Berent
The opioid crisis will be the focus of Tuesday night's Kalamazoo County Commission meeting.
Commissioners will discuss whether or not to join a statewide, multi-million dollar lawsuit against some of the largest drug makers and pharmacies in the world.
The lawsuit, including about 50 Michigan cities and counties, would hold pharmaceutical companies, distributors and pharmacies accountable for the growing opioid epidemic in the last 10 years.
Many commissioners tell Newschannel 3 they are split on the issue.
Joining the lawsuit could mean millions of dollars for Kalamazoo County, according to Stephanie Moore, the county commission chair. She said it would go toward expanding treatment, support and educational programs for those affected by opioids.
"I think people think about this as a 'oh this is a fundraiser or a way for the county to gain dollars' -- this is not what this is," said Moore. "We have a crisis, a health crisis, and this is only a tool to help us to better address that crisis."
On the other side, Commissioner Dale Shugars said this is not the answer to the crisis. He said though Pfizer is not named in the lawsuit, this legal action could create a hostile climate in the county, especially as the company is proposing an $800 million expansion in Portage in the next five years.
"I think there's a majority of commissioners who would support this, but I'm not one that's going to support it because in the long run, I don't think it's going to solve the opioid epidemic. But I think it could cause some unintentional consequences, the slippery slope, and it could cost some jobs down the road," said Shugars.
Moore said commissioners have met with law firms about joining the suit, but have not made a decision yet.
They will discuss the issue before the public at 4 p.m. Tuesday at the meeting of the whole at the Kalamazoo County Administration Building.
The public is invited to listen in and give input. A vote could come as soon as Tuesday's meeting.
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North Royalton joins litigation over opioid epidemic
Apr 2, 2018 | Cleveland.com (OH)
By Bob Sandrick
North Royalton is the latest city to join litigation against drug manufacturers and distributors over the nation's opioid epidemic. The city joins dozens of governmental agencies in several states, including a number of other Northeast Ohio communities.
On March 20, North Royalton City Council unanimously agreed to hire Kelley & Ferraro LLP, a Cleveland law firm, to represent the city in the legal action. The city is seeking damages, although a monetary amount has not been determined.
"We are accumulating and transferring information to Kelley & Ferraro about the expenses the city has borne treating people who are overdosing, and the strain that puts on our resources, including manpower at the Police and Fire departments, and the cost of Narcan (an antidote for heroin overdoses)," said Tom Kelly, North Royalton's law director.
In joining the litigation, North Royalton is following in the footsteps of Broadview Heights, which entered the legal fray over opioids earlier this year, and Strongsville, where City Council hired a law firm to represent that city in the opioid litigation just one day before North Royalton council did the same.
U.S. District Judge Dan Polster is presiding over more than 200 lawsuits -- filed by governmental entities in Alabama, California, Illinois, Ohio, Washington and West Virginia -- blaming drug manufacturers and distributors for the opioid crisis.
The lawsuits say that drug makers overstated the benefits and downplayed the risks of using opioids, and that distributors failed to monitor suspicious orders of prescription opiates. Their actions have led to overdose deaths across the country, the lawsuits say.
Pharmaceutical industry lawyers have stated that the federal government has determined their painkillers are safe and effective when used properly. They say the lawsuits have failed to identify even one physician who prescribed an opioid medication when it was medically unnecessary, or who prescribed such a medication due to misleading marketing or promotional materials.
Under its contract with Kelley & Ferraro, North Royalton will not pay a legal fee unless it wins a monetary award. The city would give the law firm 25 percent of any settlement, verdict or recovery of any kind.
The terms are different than those in Broadview Heights' and Strongsville's contracts with Climaco, Wilcox, Peca & Garofoli Co. LPA in Cleveland and Napoli Shkolnik PLC in New York City.
Under those contracts, Broadview Heights and Strongsville will give Climaco Wilcox and Napoli Shkolnik 10 percent of any amount awarded before the complaint is filed; 20 to 25 percent after legal briefs are submitted; 33 percent after a final pretrial; and 40 percent once a trial begins.
"Kelley & Ferraro offered us a fixed (25 percent) fee with no sliding scale," Kelly said. "It's very likely they will get past the legal-briefs stage, and under Climaco's contract, their fee could go up to 40 percent. I believed we would do better with 25 percent across the board."
Other local municipalities, including Brunswick, Cleveland, Elyria, Lorain and Parma, have filed lawsuits over the opioid epidemic. All of those cases have been consolidated in Polster's courtroom.
In February, the state of Ohio sued four opioid distributors, accusing them of unsafe practices. Cuyahoga County filed a lawsuit last year.
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County debates joining lawsuit against opioid manufacturers
Apr 3, 2018 | CJOnline (KS)
By John Green
Though not convinced drug manufacturers are to blame for opioid abuse in Reno County, the Reno County Commission on Tuesday will consider joining a multi-state lawsuit against those manufacturers to recover costs of responding to the epidemic.
The county was approached several months ago by a Wichita-based law firm asking it to join the suit against several major pharmaceutical companies, County Counselor Joe O’Sullivan advised.
The commission met in executive session about four weeks ago to discuss the suit and then brought it up again in last week’s open meeting.
The suit
A suit initially was filed in a district court in Ohio. Since then, law firms in West Virginia, Florida, Texas, Mississippi, and now Kansas have filed similar suits, which will all likely be joined by the court into a single class action suit.
“You’ve all read and heard about the growing problems in many segments of the country,” O’Sullivan said. “The lawsuit accuses the companies of spending money on marketing that trivializes the danger while overstating its use to address chronic pain, and also lobbying doctors about the safety of using opioids.”
The firms involved, O’Sullivan said, believe a settlement will eventually resolve the suit.
“They’d like to do it by the end of the year,” O’Sullivan said. “A lot of people think that’s optimistic and it’s not going to happen, but in the event Reno County wants to participate, it’s important to do it sooner than later.”
The suit to be filed in federal court in Wichita by the McHugh Fuller Law Group names Johnson and Johnson, as well as some other major pharmaceutical companies, O’Sullivan said.
The petition, which is 155 pages long, accuses the manufacturers of engaging in false and deceptive practices in their marketing, that the companies engaged in “unlawful distribution,” and that they “failed to prevent diversion” of the drugs.
Alternative theories, O’Sullivan said, are that the companies have created a public nuisance and that they are engaged in racketeering.
Joining the suit, O’Sullivan said, will cost the county nothing, win or lose.
Under the contract, the law firm will split any money awarded between the participating parties after taking off 30 percent of the total gross recovery, less costs and expenses of the suit. If the court awards attorney fees, the law firm will take whichever is greater, the awarded fees or an amount equaling 30 percent.
What losses?
“I asked the attorney what proof they have to have that Reno County was damaged by this type of activity,” O’Sullivan told the commission. “Many are not damages suffered by the county, but they include treatment care costs, education costs of children not cared for, damages as a result of incarceration, shoplifting, long-term rehabilitation costs, and public awareness costs to teach physicians and children the dangers of opioids.”
There are also emergency response costs, hospitals costs, administrative costs for the county and departments that deal with the issue, law enforcement costs, and lost revenues.
“There is no statistical information I’m aware of by which Reno County could claim damages,” O’Sullivan said.
The law firm filing the suit will develop a “damages model” that would be used by each participant in the suit to determine their share of damages.
“Ostensibly, everyone in the country who shares in the consequences would get a settlement, such as was achieved in the tobacco case,” O’Sullivan said. “I don’t know what the criteria will be (to allocate any settlement.)”
If it participated and received an award, Reno County would not be obligated to use the money for any specific purpose, O’Sullivan said.
“We could use it for any purpose we wanted,” he said.
Reno County Deputy District Attorney Tom Stanton also addressed the commission on the opioid issue.
“I’m here to tell you there is a drug problem in Reno, but not to influence your decision on whether to join the lawsuit,” Stanton said.
Hard to place blame...
He attended a conference recently where the issue was discussed, and learned “a large percentage of what we see now, as far are overdoses, are not directly the result of legally manufactured drugs themselves,” Stanton said.
“We’re receiving into this country shipments of fentanyl from Mexico the Middle East and China,” he said. “These are much more powerful – 50 to 100 times more powerful – than the narcotic drugs lawfully being manufactured. In many cases, people are pressing these into pills that look like prescription narcotics.”
There was a case recently, he said, in which investigators believed they had seized oxycodone pills, but a lab analysis showed them to be fentanyl.
The lasts
“The problem is, if you look at the 64,000 overdose deaths in 2016, you have to look at what drugs were used and whether they were actually manufactured from the defendant companies or produced in clandestine labs.”
Stanton pointed out that the Wichita petition references instances where manufacturers have been fined for not addressing the diversion issue.
The ways people are diverting the pills, he said, include teens taking them from their parents or grandparent’s medicine cabinets, pharmacy burglaries and “doctor shopping.” The latter issue has been about the only one that can be directly addressed, by physicians sharing names of patients prescribed opioids.
“The point I want to make is basically I’m not sure how you relate damages that might be incurred by the county to drug manufacturers, given the influx of drugs from outside,” Stanton said. “I’m sure there’s an amount of greed involved by some manufacturers and distributors... but I’m not sure how a lawsuit can attribute the problems we have in Reno County.”
O’Sullivan, responding to a question from the commission, said the law firm had invited at least 16 municipalities to join the suit, but only a couple have entered so far.
... But why not?
“I don’t like this kind of lawsuit personally, to try to pin financial responsibility on manufacturers,” Commissioner Dan Deming said. “Though they share some portion of the blame for the overall opioid crisis, if we don’t have any costs to pursue...”
If there’s going to be a settlement “somewhere down the line,” however, Deming said, “shouldn’t we be a part of it?”
“It is low hanging fruit,” O’Sullivan replied.
“Do we want to wake up in three years and find out counties that joined are getting $500,000 and we did not?” Deming asked. “Do we have an obligation to get involved if there’s any chance taxpayers will be reimbursed for costs that are out there? How do we defend not being a part of it, quite frankly?”
“I guess I agree with you Dan,” said Commissioner Bob Bush. “I don’t mean to be too much of a Boy Scout. I’m not a fan of participating in things that don’t fit us. But the point has been made we have significant costs in the community through law enforcement and the hospital system, through the DA’s office and their resources. There are costs incurred, and if we paint with a broad enough brush, we can fit within the lawsuit, so I support that we join it.”
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New legal tool could be used in the opioid epidemic battle
Apr 2, 2018 | WLOX (MS)
By Doug Walker
A new tool is being considered in the continuing battle against the opioid epidemic sweeping the country and the coast. That tool is the lawsuit. Harrison County supervisors voted Monday to consider filing litigation against the makers of narcotic painkillers and those who prescribe them.
"The cost of this opioid epidemic is tremendous. It's a tremendous cost to the taxpayers. You've got your hospitals, your inmates, mental health treatment, all of these services," Supervisor Beverly Martin said.
That burden on taxpayers is widespread, even in jails.
"It impacts us because we arrest people for it, obviously," Harrison County Sheriff Troy Peterson said. "It impacts us because we're housing people for drug addiction instead of crimes. It makes our numbers go up in the jail tremendously for housing people that are waiting to go to rehab."
Similar to the tobacco wars of 20 years ago, taking on big medicine is risky, but worth it for Supervisor Marlin Ladner.
"I think we have to take the chance and see if we can help our local taxpayers. Because this thing is going to get out of hand, it's costing a lot of money," Ladner said.
That money adds up for paramedics and other first responders.
"It absolutely is the training that we have to have, in case," Harrison County Fire Marshal Pat Sullivan said. "It's the equipment that we have to buy, in case. In addition to the fact that we are rolling, we have to be prepared for it, so we're spending money even if we don't roll out of the station."
With Harrison County potentially suing pharmaceutical companies, they're taking on an industry worth hundreds of billions of dollars, with plenty of lobbying power. But still, they are confident.
"The lawyers that have been doing this have done this in the past, and they're very well schooled in it and the evidence is pretty strong. There has been a proliferation of this type of medication just being fully available over the last 10 years to the point that it's become an epidemic," Harrison County Attorney Tim Holleman said.
As of now, there has been no timetable set for any litigation to be filed against pharmaceutical companies or doctors who over-prescribe opioids.
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Montgomery County suing opioid manufacturers and distributors
Apr 3, 2018 | WSFA (AL)
By Staff
Montgomery County is the latest local government to file suit against prescription drug manufacturers and distributors.
The suit implicates the companies in the ongoing opioid crisis.
Beasley Allen filed the lawsuit on behalf of Montgomery County, claiming the marketing of these drugs has contributed to the opioid epidemic.
"Responding to the opioid crisis has required Montgomery County to sustain economic damages and to continue to bear a significant financial burden," according to Beasley Allen.
Nationally, opioids are responsible for killing more than 183,000 people since 1999, according to the Centers for Disease Control and Prevention.
Beasley Allen has filed similar lawsuits on behalf of a number of Alabama municipalities and counties, as well as several governmental entities in other states.
The firm also is representing the State of Alabama in its opioid lawsuit against Purdue Pharmaceuticals.
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Chatham Co. sues opioid manufacturers, distributors
Apr 2, 2018 | WTOC (GA)
By Zach Logan
Chatham County is currently in the discovery period as it works to try and be reimbursed for the money spent dealing with the opioid crisis.
Last month, the county filed a suit against several drug companies and manufacturers. The county claims they've spent millions of dollars cleaning up the mess left by opioid makers and sellers.
Mark Tate is the lawyer representing Chatham County in this case.
"The evidence is going to show [the drug companies] started conspiring as many as two and a half decades ago to try and increase the level of prescriptions of these pharmaceuticals," Tate said.
Tate says several drug manufacturers and companies told physicians they needed to treat pain with opioids. If they didn't, then Tate says the companies would tell doctors that they were committing malpractice.
The suit also claims drug manufacturers created the term "pseudoaddiction."
"And therefore, it's not real addiction. And the treatment, mysteriously and magically, for 'pseudo-addiction' is more opioids. So, they got people more and more addicted to these medications," Tate said.
Chatham County is just one of several counties taking drug manufacturers to court. Beaufort County filed a suit back in February. Lawyers say it comes after counties have had to commit several different resources fighting the opioid epidemic.
"The cost we don't deserve to bare that essentially has subsidized and made the pharmaceutical companies very, very wealthy," Tate said.
Tate says Chatham County has 90 prescriptions for every 100 residents. The lawyer says first responders, DFCS, jail and medical personnel have had to devote resources in order to clean up after the drug manufacturers.
"This lawsuit is about ending our taxpayer subsidy to big drug companies, manufacturers, and distributors," Tate said.
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Rhode Island hires Motley Rice for potential opioid litigation
Apr 2, 2018 | Reuters
By Nate Raymond
Rhode Island’s attorney general has hired a law firm to represent the state in potential litigation against opioid manufacturers and distributors.
Attorney General Peter Kilmartin on Friday announced that his office had retained the plaintiffs’ law firm Motley Rice in anticipation of a lawsuit that would seek to recover damages the state incurred as a result of the opioid epidemic.
The remainder of this article is under paywall at: https://www.reuters.com/article/health-opioids/rhode-island-hires-motley-rice-for-potential-opioid-litigation-idUSL2N1RG00A
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Towns Consider Joining Federal Suit in Opioid Epidemic
Apr 2, 2018 | Vineyard Gazette (MA)
By Holly Pretsky
Island towns are considering joining multi-district litigation to fight prescription opioid manufacturers and distributors.
“This is a problem that really we are all dealing with, and the expenses have filtered down to municipalities,” said Lauren Goldberg, an attorney with the firm KP Law, who briefed West Tisbury selectmen on the case Thursday evening. “You speak to firefighters, and they will tell you that before they used to respond to fires. Now, they respond to overdoses.”
Representatives from other towns including Chilmark selectman Jim Malkin, Chilmark town administrator Tim Carroll, Aquinnah town administrator Jeffrey Madison, Aquinnah selectman Jim Newman, and Oak Bluffs selectman Michael Santoro were also at the meeting.
Ms. Goldberg said about 75 municipalities in the commonwealth and hundreds of municipalities in other states had already joined the suit, which is being litigated in a federal court in Ohio. The suit alleges that opioid manufacturers and distributors knew the substances were addictive and chose to aggressively market them as safe anyway, creating an addiction cycle that benefitted their business. It also alleges the companies failed to report suspicious orders of the drugs.
Plaintiffs in the case argue that municipalities have born the burden of significant costs from the opioid crisis, and those costs are not limited to loss of life from overdoses. Attorneys point to education expenses, the cost of the overdose reversal drug Narcan, costs associated with welfare services for children of addicts, and the cost of addiction task forces as examples of damages
Ms. Goldberg said joining the suit would cost towns nothing, and she was optimistic about winning a settlement from the pharmaceutical companies.
“It is anticipated that there will be two types of recovery: one going back for what you’ve spent, and one looking forward, a kind of fund to pay for education, ongoing public safety and enforcement costs, and treatment costs,” she said.
Joining the suit would also make a powerful political statement, she said.
She said if the suit is unsuccessful, towns would not be responsible for expenses. The only potential cost to towns would be associated with compiling data for the case.
After Ms. Goldberg outlined the case for about 30 minutes, selectmen had questions. West Tisbury chairman Skipper Manter was curious why the case targeted the pharmaceutical companies rather than the doctors who write prescriptions for opioids or the insurance companies who pay for the prescriptions.
“Sometimes I don’t think you’re going after the doctors hard enough,” he said. “I think that’s where most of the focus needs to be,” he said.
West Tisbury selectman Cynthia Mitchell asked how settlement funds for future expenses would be distributed among towns. Ms. Goldberg said that formula was yet to be formally determined.
The other town representatives had multiple questions for Ms. Goldberg as well, but conversation about the issue was cut short because the room at the Howes House was needed for another meeting.
In other business, selectmen revisited the possibility of creating a so-called host community agreement with the Island’s first medical marijuana dispensary before it opens for business. Other towns in the commonwealth have used such agreements to require dispensaries to pay thousands of dollars in extra fees each year, citing extra law enforcement and public health expenses associated with marijuana.
West Tisbury selectmen seemed to prefer to wait and see what kind of costs might arise before charging the dispensary in a host agreement.
“It’s very hard to put a finger on something that doesn’t exist yet,” said Mr. Manter. “I don’t see this particular business putting any more financial burden on our existing resources than any other business.”
“There’s one difference,” said town attorney Ron Rappaport. “We couldn’t tax any other business because it would violate Massachusetts law. But Massachusetts law says that we can tax this business.”
Geoff Rose, owner of the medical marijuana facility in question, attended the meeting and disputed whether host community agreements are currently required, citing Department of Public Health regulations. Selectmen said the agreements are allowed whether they are required or not.
Given the uncertainty about exactly what kind of costs could arise related to the business, selectmen asked Mr. Rappaport to draft an agreement that charges a modest fee for the first year and allows for review each year.
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Northern Arapaho Tribe Sues Drug Companies Over Opioid Epidemic
Apr 3, 2018 | K2 Radio
By STaff
The Northern Arapaho Tribe has sued six pharmaceutical companies and three drug distributors that do business in Wyoming for the harm done to tribal members by the opioid crisis, according to a lawsuit filed in federal court on Monday.
"The Tribe has seen child welfare and foster care costs associated with opioid-addicted parents skyrocket, their health services have been overwhelmed, education and addiction therapy costs have substantially increased, and almost every tribal member has been affected," according to the 109-page compliant filed by the Tribe's attorneys.
The Tribe wants a jury trial to recover from the drug companies actual and consequential damages; their revenues and profits from opioid distribution; past and future expenses caused by the epidemic; compensatory damages for treating addicted patients and infants born with opioid-related medical conditions; costs for care of children whose parents suffer from opioid-related disabilities; costs for public safety; and other damages.
The Tribe is suing the defendants under laws about public nuisance; the Racketeer-Influenced and Corrupt Organizations Act; the Lanham Act that forbids using false or misleading information about a good or service; deceptive trade practices; fraud; negligence and gross negligence; negligence per se by misrepresenting the risks and benefits of their products; unjust enrichment; and civil conspiracy.
The manufacturing defendants are:Purdue Pharma, which makes and sells opioids such as OxyContin and Dilaudid. OxyContin is Purdue's best-selling opioid, with annual sales ranging between $2.47 billion and $2.99 billion since 2009.Cephalon makes and sells Actiq and Fentora.Janssen makes and sells fentanyl, an opioid 80 to 100 times more powerful than morphine.Endo Health Solutions develops, markets and sells Opana, Percodan, Percocet and Zydone, as well as generic opioids including oxycodone, oxymorphone, hydromorphone an hydrocodone.Allergan PLC manufactures and sells Kadian and Norco. Allergan includes Watson Laboratories, Actavis Elizabeth LLC, and Teva Ltd.Mallinckrodt PLC makes and sells oxycodone.
Other tribes have sued opioid manufacturers and distributors. In January, three tribes in South Dakota sued many of the same defendants.
On March 5, three tribes filed a similar lawsuit in federal court in Tacoma, Wash.
In response to the three tribes' lawsuit in Washington state, Purdue Pharma denied the allegations. A company spokesman told the Kitsap Sun in Bremerton, Wash., "We are deeply troubled by the prescription and illicit opioid abuse crisis, and we are dedicated to being part of the solution. As a company grounded in science, we must balance patient access to FDA-approved medicines, while working collaboratively to solve this public health challenge.”
The Northern Arapaho Tribe's lawsuit also named the top three distributors of prescription opioids: AmerisourceBergen, Cardinal Health and McKesson.
The lawsuit outlines the modern history of the use of opioids. Before 1990, medical practice standards dictated opioids only should be used for acute pain, post-surgical pain, or end-of-life care. Doctors generally did not prescribe opioids for chronic pain because of the risks of addiction.
But pharmaceutical companies needed to change this if they wanted larger and more lucrative markets, so they persuaded doctors to unwittingly prescribe huge amounts of opioids, according to the lawsuit. "Defendants also intentionally neglected their obligations to prevent diversion of the highly addictive substance."
In 2016, the national average rate of dispensed opioid prescriptions was 66.5 per 100 persons. In Wyoming, the average was 71.1 per 100. In Fremont and Hot Springs counties, where tribal members live, the rates were 83.3 per 100 and 98.1 per 100 respectively.
The effects on American Indian communities nationwide are disproportionate, according to the lawsuit. The U.S. Centers for Disease Control reported in 2012 that one in 10 American Indians over 12 used prescription pain medicine for nonprescription purposes, compared to one in 20 whites and one in 30 African Americans.
Drug overdose deaths among all Americans increased more than 200 percent between 1999 and 2015, but they increased 500 percent among American Indians and native Alaskans during the same time.
Meanwhile, use and death rates from heroin -- often used when opioids are not available -- for whites and American Indians has also skyrocketed.
The Northern Arapaho Tribe asserts opioid manufactures and distributors have spent millions of dollars "on promotional activities and materials that falsely deny or minimize the risks of opioids while overstating the benefit of using them for chronic pain."
The defendants have downplayed the seriousness of addiction, exaggerated the effectiveness of screening tools to prevent addiction, claimed opioid dependence and withdrawal are easily managed, and denied risks of higher dosages, among other actions, according to the lawsuit.
To further their business, they created third-party front groups to promote the use of opioids and to oppose critical articles and potential regulations.
The companies also fostered an illicit market for opioids by allowing drugs to be transferred from a legitimate distribution channel or use to illegitimate ones.
The disruption in the supply chain included distributors not monitoring doctors who bought large quantities of commonly abused opioids; drugs lost or stolen in transit; pharmacists filling prescriptions without questioning their medical purpose; people traveling long distances to fill prescriptions; and forging prescriptions.
These practices directly affected the Northern Arapaho Tribe.
"The Distributor Defendants knew or should have known that the opioids being diverted from their supply chains would contribute to the opioid epidemic faced by the Tribe, and would create access to opioids by unauthorized users, which, in turn, perpetuates the cycle of addiction, demand, illegal transactions, economic ruin, and human tragedy."
While not mentioned in the lawsuit, some customers of former Casper Dr. Shakeel Kahn would obtain prescriptions for opioids -- bought for $500 in cash at his office -- and distribute them in the Wind River Reservation. (Kahn is in custody awaiting trial in federal court on multiple counts related to distribution of opioids.)
But the lawsuit does state that about 60 percent of the opioids that are abused in the Tribe come directly or indirectly through doctors' prescriptions.
The consequences are wide and deep, according to the lawsuit:
"Many patients who become addicted to opioids will lose their jobs. Some will lose their homes and their families. Some will get treatment and fewer will successfully complete it; many of those patients will relapse, return to opioids or some other drug. Of those who continue to take opioids, some will overdose -- same fatally, some not. Others will die prematurely from related causes -- falling or getting into traffic accidents due to opioid-induced somnolence; dying in their sleep from opioid-induced respiratory depression; suffering assaults while engaging in illicit drug transactions; or dying from opioid-induced heart or neurological disease. The opioid epidemic undermines the ability of the Tribe to self-govern and to maintain and develop economic independence."
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Carson City Board of Supervisors to consider joining lawsuit on opioids
Apr 2, 2018 | Nevada Appeal (NV)
By Anne Knowles
The Board of Supervisors on Thursday will consider whether to join a lawsuit against opioid manufacturers and distributors.
The suit would seek to recover monetary damages for harm to the city and its resources caused by the opioid epidemic.
The supervisors will first hear a presentation by Eglet Prince, a Las Vegas-based personal injury law firm, on the impact of opioids on Nevada counties, including Carson City.
After the presentation, the board will vote whether to enter into a contingency fee agreement with the law firm, which would be 25 percent of the recovery from the suit.
The board will also review and advise staff on the city's waste management services request for proposal. The current contract expires in June next year and the city is considering changing the way it does trash and recycling pick up.
According to the staff report, the staff is looking for guidance on franchised residential and commercial service; mandatory residential service; automated trash and single-stream recycling service; and yard waste service.
The supervisors will hear about a proposed affordable housing project. The Valley Springs Apartments project would include 61 units in a multi-family development on about 2 acres at 680 Hot Springs Road.
The first phase consists of 28 units: three will be designated as eligible to households earning not more than 30 percent of the area median income (AMI) with the remaining 25 units eligible to household incomes at or below 60 percent AMI. Six special needs units will be offered as a priority to veterans with special needs and the overall project will provide preference for vets living under 60 percent of AMI.
The board will vote whether to authorize Mayor Bob Crowell to sign a letter acknowledging an application from Northern Nevada Community Housing to the State of Nevada for the use of HOME Investment Partnership Funds as part of the financing for the project.
The supervisors also will consider a couple contracts, a $300,000 contract for emergency services transportation and $258,233.62 for new radios, as well as hear the first reading of the new restaurant inspection policies.
The Board of Supervisors meet at 8:30 a.m. in the Sierra Room, Carson City Community Center, 851 E. William St.
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Apr 3, 2018 | Montgomery, AL
By WAKA (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33987910?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript: a lawsuit filed b the beasley allen law firm alleges the marketing the drugs contributed to the opioid epidemic. the lawsuit states montgomery and three other alabama cities ranked in the top 15 places in the country with the highest opioid abuse. companies named in the suit include perdue pharma and johnson and johnson.
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Apr 3, 2018 | Raleigh-Durham, NC
By WRAL (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33987957?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript;: the u.s. justice department wants to join settlement talks and lawsuits against manufacturers and distributors of opioid pain killers. more than 400 states and counties across the country are suing drugmakers for costs associated with opioid addiction. the government said it can provide information and expertise. the attorney general jeff sessions wants to so the nation's unprecedented drug cris come to an end.
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Apr 3, 2018 | Philadelphia, PA
By WFMZ (WFMZ)
Video Link: http://app.criticalmention.com/app/#clip/view/33987953?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript: the department of justice wants to join settlement talks in federal court involving hundreds of lawsuits against manufacturers and distributors of opioid painkillers. the government says it can provide information and expertise to parties in the case and facilitate requests to government agencies. yesterday... the -oj made a request to join as a "friend o the court" in a court filing over 400 cities and counties across the country... including lehigh county... have sued drug makers and distributors for costs associated with the addiction crisis.
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Apr 3, 2018 | WMC (NBC)
By WMC (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33987974?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript: pulaski county is the latest arkansas county joing a lawsuit against dozens of drug manufacturers. vo the lawsuit was first filed last month in crittenden county circuit court. more than 50 opioid manufacturers are named as defendants. the counties claim the companies misrepresented the risks of those drugs.. they argue that the manufacturers, retailers, prescribers and distributors of the drugs should pay for treatment.
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Apr 3, 2018 | Salt Lake City, UT
By KSL (NBC)
Video Link: http://app.criticalmention.com/app/#clip/view/33988028?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript: another utah county announces its plans to sue pharmaceutical companies over opioid addictions. 3 tooele county has one of the highest rates of overdose deaths in the state. attorneys who filed the suit say drugmakers for decades concealed the risks associated with painkillers.two dozen companies are named in the lawsuit.... including purdue pharma, the name-brand opioid oxycontin... and endo pharmaceuticals... which produces percocet.the lawsuit mirrors a claim filed by summit county late last month... and is one of dozens across the country.
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Apr 3, 2018 | Savannah, GA
By WTOC (CBS)
Video Link: http://app.criticalmention.com/app/#clip/view/33988037?token=6f7f5db3-498e-486f-8f70-76216e6ac0db
Rough Transcript: chatham county wants to be reimbursed for the money spent dealing with the opioid crisis. the county has filed a lawsuit which includes several opioid manufacturers and distributors. mark tate is the lawyer who is representing chatham county in this case. the county claims it's spent millions of dollars cleaning up the mess left by opioid makers and sellers. according to the lawsuit, the drug companies used false information to sell more opioids. tate says the suit has been filed and the county is now hoping it can negotiate a settlement. . "during this time we're going to do the best we can to make sure chatham county gets the most of money as a result of the damages they suffered because of opioids. so that's the next step and if we are unable to successfully resolve the case then it will come back to chatham county where we will try it in federal court."
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