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Opioid Litigation Daily Media Report - 4/11/18

Salt Lake County, UT Suit

With Utah debating its options for suing the world’s biggest pharmaceutical companies, Salt Lake County files an opioids suit of its own
Apr 10, 2018 | The Salt Lake Tribune (UT)
By Taylor W. Anderson

Salt Lake County sued several of the world’s largest pharmaceutical companies Tuesday for what it says are the burdens opioid medications and misleading business practices have placed on Utah’s largest county.
'Enough is enough': Salt Lake County sues pharmaceutical firms, doctors over opioid crisis
Apr 10, 2018 | Deseret News Utah (UT)
By Ben Lockhart

Salt Lake County filed a lawsuit Tuesday against pharmaceutical companies and medical professionals, alleging the scourge of opioid addiction in the county "stems directly from a callously deceptive marketing scheme that was spearheaded by certain opioid manufacturers and perpetuated by prominent doctors they bankrolled."
"Those Were Lies": Salt Lake County Sues Big Pharma For Deceiving the Public
Apr 10, 2018 | KUER (UT)
By Whittney Evans

Salt Lake County has assembled a group of high-profile attorney’s to take on 19 pharmaceutical companies over their role in the opioid crisis.
Salt Lake County files suit against opioid manufacturers
Apr 10, 2018 | Good4Utah (UT)
By Glen Mills

Utah's biggest county announced it's joining a growing list of local municipalities who are taking opioid manufacturers to court.
Ben McAdams, Sim Gill announce next step in opioid lawsuit
Apr 10, 2018 | KUTV (UT)
By Tiffany Justice

Another large county is joining the fight against the opioid crisis. Salt Lake County Mayor Ben McAdams, along with District Attorney Sim Gill announced the next step in their lawsuit.
Salt Lake County sues Big Pharma over opioid crisis
Apr 10, 2018 | Fox 13 (UT)
By Ben Winslow

County leaders are filing a lawsuit against pharmaceutical giants over the opioid crisis.

Commentary & FYIs

Study: Despite decline in prescriptions, opioid deaths skyrocketing due to heroin and synthetic drugs
Apr 10, 2018 | The Washington Post
By Katie Zezima

Fatalities from heroin and black-market synthetic opioids skyrocketed while the nation saw a decline in the number of opioid painkiller prescriptions and the overdose deaths attributed to them, according to a new study.
Major push to combat opioid abuse doesn’t include bill to restore DEA powers
Apr 11, 2018 | Washington Examiner (DC)
By Robert King

Congress is expected to make a major push in the next few months to approve dozens of bipartisan bills to combat the opioid epidemic.
Congress searches for prescription to help fight growing opioid epidemic
Apr 11, 2018 | USA Today
By Michael Collins

The opioids epidemic that is ripping apart lives across the country appears to be uniting Republicans and Democrats in Congress.
Doctors bristle at push for opioid prescription limits
Apr 11, 2018 | The Hill
By Rachel Roubein

An increasing number of states and entities in the health industry are putting curbs on the amount of opioids that doctors can prescribe, a controversial move aimed at combating the opioid crisis.
Portland VA study says that patients have same long-term pain with or without opioids
Apr 11, 2018 | OregonLive (OR)
By Molly Harbarger

Patients who swap opioids for other therapies might not experience much difference with chronic pain, according to a new study from a Portland researcher.
Will Surgeon General’s Opioid Overdose Plan Make a Dent in Drug Crisis? (Opinion)
Apr 10, 2018 | Healthline
By Daivd Mills

“First, do no harm” is one of the promises most medical students make as they become doctors.
Other Views: Opioids Lawsuit Makes Sense, Just as Tobacco Suits Did (Opinion)
Apr 10, 2018 | The Chronicle (WA)
By Editorial Board

Thurston County commissioners made a good call recently to join other Washington counties and cities in a federal lawsuit against the makers of opioids.

Southeast (FL, TN, GA)

County approves new lawsuit against Big Pharma
Apr 10, 2018 | Osceola News Gazette (FL)
By Rachel Christian

Local government approved another legal measure Monday aimed at combating the opioid crisis in Osceola County.
City of St. Augustine notebook: Commission allows demo of Echo House
Apr 11, 2018 | The St. Augustine Record (FL)
By Sheldon Gardner

Commissioners discussed the possibility of suing pharmaceutical companies in response to the opioid crisis, something that is happening in other areas. But they didn’t make a decision on Monday. City officials plan to provide details about the cost of the crisis on St. Augustine at the next Commission meeting.
Suing Big Pharma
Apr 10, 2018 | Citizen Tribune (TN)
By Staff

Appetites whetted by the multi-billion dollar settlement with Big Tobacco 20 years ago, counties across the nation are suing Big Pharma to recover costs associated with the opioid epidemic. But in Tennessee, Attorney General Herbert Slatery doesn’t want just a piece of that pie, but all of it.
Catoosa County Takes on Drugmakers With Opioid Lawsuit
Apr 10, 2018 | Law.com
By Katheryn Tucker

A small county in Northwest Georgia has joined the litigation battle against makers and sellers of opioid drugs.
Lawmakers lament lack of opioid legislation
Apr 10, 2018 | Valdosta Daily Times (GA)
By Jill Nolin

Two key state legislators lamented the recent failure of measures aimed at curbing the opioid crisis in Georgia at a task force meeting held Monday.

Midwest (MI, IA, OH)

Jackson considers joining other communities in opioid lawsuit
Apr 10, 2018 | WLNS 6 (MI)
By Aaron Dimick

Communities across the state have spent millions of dollars to battle the opioid crisis. And now they want the drug companies to pay.
City manager appointment, opioid litigation, public comment rules on council agenda
Apr 10, 2018 | Michigan Live (MI)
By Taylor Desormeau

City Manager Patrick Burtch's potential appointment to the Downtown Development Authority, and a new set of council meeting citizen guidelines are among the topics at the next Jackson City Council meeting.
Cerro Gordo County supervisors table opioid resolution recommendation
Apr 10, 2018 | Globe Gazette (IA)
By Steve Bohnel

After a roughly 15-20 minute discussion with Cerro Gordo County Attorney Carlyle Dalen, the Cerro Gordo County Board of Supervisors decided to table a resolution to join a joint lawsuit against out-of-state opioid manufacturers.
Council hears presentation on opioid lawsuit
Apr 10, 2018 | The Times-Bulletin (OH)
By Kirsten Barnhart

City Council heard a presentation from lawyer Al Smith regarding opioid litigation. He urged the City to join a lawsuit against pharmaceutical companies for wrong doing.

Northeast (MA, PA)

Easton joins opioid lawsuit
Apr 10, 2018 | Wicked Local (MA)
By Donna Whitehead

The Board of Selectmen voted Monday, April 9, to join the Massachusetts Opioid Litigation Attorneys in suing pharmaceutical companies and distributors to recover municipal costs that have been incurred as a result of the opioid crisis.
County: ‘Big Pharma’ lawsuit still ongoing
Apr 11, 2018 | Sun-Gazette (PA)
By Katelyn Hibbard

Suing “Big Pharma” still is on the table, confirmed Lycoming County commissioners Tuesday.

Southwest (TX)

County officials just say no to opioid lawsuits
Apr 10, 2018 | SF Texas Record (TX)
By Staff

Remember how self-styled sophisticates howled with laughter when First Lady Nancy Reagan introduced the new slogan for the “War on Drugs” effort back in the 1980s?

Northwest (WA)

County weights joining opioid lawsuit
Apr 10, 2018 | South Whidbey Record (WA)
By Laura Guido

The Board of Island County Commissioners held a round-table discussion last week to consider whether to join multi-district litigation against prescription opioid manufacturers.

Broadcast Media Coverage

FOX 13 News Live at 5:30
Apr 10, 2018 | Salt Lake City, UT
By KTSU (Fox)

Video Link: https://app.criticalmention.com/app/#clip/view/34161505?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
2News This Morning at 7A
Apr 11, 2018 | Salt Lake City, UT
By KUTV (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34161557?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
Good Morning Utah
Apr 11, 2018 | Salt Lake City, UT
By KTVX (ABC)

Video Link: https://app.criticalmention.com/app/#clip/view/34161638?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
6 News This Morning
Apr 11, 2018 | Lansing, MI
By WLAJ (ABC)

Video Link: https://app.criticalmention.com/app/#clip/view/34161750?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
CBS 8 News This Morning
Apr 11, 2018 | Montgomery, AL
By WAKA (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34161421?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
KIRO 7 News 5:00PM
| Seattle, WA
By KIRO (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34162698?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110

Salt Lake County, UT Suit

With Utah debating its options for suing the world’s biggest pharmaceutical companies, Salt Lake County files an opioids suit of its own

Apr 10, 2018 | The Salt Lake Tribune (UT)

By Taylor W. Anderson

Salt Lake County sued several of the world’s largest pharmaceutical companies Tuesday for what it says are the burdens opioid medications and misleading business practices have placed on Utah’s largest county.
In filing a lawsuit of its own in state court, the county opted to avoid a political debate that has played out at the state level over whether and how to enter the courtroom with a number of companies and physicians who distributed their products over the past two decades.
The county instead will attempt to tell its own story of residents’ troubles with opiate addiction, overdoses and homelessness in recent years, and of the strain the response to that suffering has put on Salt Lake County services.
“Big Pharma would like to continue on making as much money as they’ve been making, so I don’t have much sympathy for them,” said Grant Woods, former Arizona attorney general and one of more than a dozen local and out-of-state lawyers working with the county on the case. “They need to pay the price here, and we’re going to make them pay the price.”
The lawsuit follows a number of others in Utah and dozens across the nation that seek to end years of allegedly misleading marketing practices that led people to become addicted to pain medication and, later, heroin and other opiates.
The county seeks changes in the marketing practices of pharmaceutical companies, which the suit says turned to doctors to spread painkiller use nationwide and in Utah. It also seeks restitution “in the amount they have been unjustly enriched” at the county’s expense, and it seeks damages for the costs the county has incurred responding to the opioid epidemic.
Salt Lake County District Attorney Sim Gill was flanked by Mayor Ben McAdams and Sheriff Rosie Rivera, all of whom talked about opioid addiction’s effect on crime and about the strain that it has put on the county’s budget and jail.
After years of drug use and other crime in downtown Salt Lake City’s Pioneer Park neighborhood near the homeless shelter, the problem boiled over and let to state, county and city intervention.
The state and county worked to rapidly provide jail and treatment beds for those arrested as Utah tried to stop the use of heroin and other drugs. At the new district attorney building, Gill said many people who use heroin in the county and across the U.S. started with prescription painkillers.
“Eighty percent of heroin addicts nationwide started with prescription drugs,” he said.
The county’s suit names as defendants Purdue Pharma, Johnson & Johnson, Janssen Pharmaceuticals, Endo Pharmaceuticals, Allergan, Watson Pharmaceuticals and affiliates.
“We are deeply troubled by the prescription and illicit opioid abuse crisis, and we are dedicated to being part of the solution,” Purdue Pharma wrote in a statement, adding that it had developed three opioid medications that have “abuse-deterrent properties.”
The filing is at least the third county-led lawsuit to name Lynn R. Webster, a physician whom the suit accuses of being “one of the most influential” doctors who supported using opioids to treat long-term pain through his Salt Lake City-based Lifetree Pain Clinic. Federal prosecutors spent years investigating Webster and the deaths of some of his patients before dropping the case in 2014.
Webster is represented by Salt Lake City attorney Peter Stirba, who said he was preparing a statement.
Summit and Tooele counties also named Webster in lawsuits they filed last month against many of the same companies. Lawsuits from Box Elder, Cache, Davis, Utah, Washington and Weber counties are expected to follow.
The counties will attempt to keep their cases in state court, and experts expect that the defendants will attempt to consolidate cases nationwide and move them into federal court.
In the meantime, Woods said, the team is prepared to go to trial and likes its chances.
“You have to be ready to try your case,” Woods said. “As I said, we’re more than happy to try. I think they’re going to get creamed if they want to try the case. If they want to try, let’s go.”The state debate
Salt Lake County’s filing also follows a monthslong and ongoing debate among Utah’s top politicians about how to proceed as states and counties line up.
House Speaker Greg Hughes, R-Draper, and Utah Attorney General Sean Reyes have disagreed for months on whether Utah should file its own lawsuit or join dozens of others in negotiating a settlement out of court. The debate led lawmakers, who prefer a single state filing, to pass a bill calling on Reyes to sue.
Despite the bill, Reyes still prefers the national settlement. Reyes and about 40 other attorneys general are working out of court with cooperating witnesses to get evidence and possibly reach a settlement, according to Spencer Austin, chief deputy over criminal matters in Reyes’ office.
Utah is working to resolve issues with a number of people and companies, Austin said, and it would consider lawsuits in state court against any company that doesn’t resolve issues during the national discussions.
“We will probably end up with feet in both camps,” Austin told The Salt Lake Tribune on Tuesday. “I think we will end up filing against certain manufacturers and distributors, [and] hope we will end up being able to resolve through the multistate” litigation.
In a late-December radio interview with The Zone, Reyes indicated that work with dozens of other states on a “giant, potential settlement” with manufacturers was already in the works, which he said was better than paying outside attorneys.
The approach frustrated Hughes, who preferred immediate action and a Utah-led lawsuit that he believes could bring a bigger settlement and substantive changes in marketing practices of the pharmaceutical companies.
Counties “have their own unique story to tell, their individual story to tell,” said Greg Hartley, chief of staff for the outgoing House speaker. “While that multistate effort is going on and they’re talking about a settlement before there’s any litigation, [Hughes is] more concerned about what’s found in the discovery phase of an actual lawsuit and court case rather than the financial gains that are received.
“He sees the multistate effort,” Hartley added, “as kind of an effort that’s being done by several state attorneys general in collaboration with the manufacturers.”
The attorney general’s office is putting together a group that would help pick a law firm that would work for the state if it sues, Austin said, and should be ready to start the search by the end of this week or next week.
Meanwhile, he said, Utah will continue working with other states to see whether it can secure a settlement that includes damages and changes to business practices.
“The financial resolution is important, particularly to the state and individuals that have been affected by this,” Austin said. “We want to help these people harmed by this epidemic. But as important to that is how the companies are going to continue to do business in the future. We believe they have engaged in what we would not considered to be good business practices.”
Woods said more state and county filings will boost pressure on the companies to agree to terms that will result in widespread change.
“There are some — I don’t think Sean Reyes is in that group — but there are some out there who want to just declare victory, get some sort of check, declare victory and move onto the next issue,” Woods said. “Most of us have zero interest in that.”

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'Enough is enough': Salt Lake County sues pharmaceutical firms, doctors over opioid crisis

Apr 10, 2018 | Deseret News Utah (UT)

By Ben Lockhart

Salt Lake County filed a lawsuit Tuesday against pharmaceutical companies and medical professionals, alleging the scourge of opioid addiction in the county "stems directly from a callously deceptive marketing scheme that was spearheaded by certain opioid manufacturers and perpetuated by prominent doctors they bankrolled."
That alleged scheme, according to the 97-page complaint the county filed in 3rd District Court, "has exacted a foreseeable financial burden on Salt Lake County," which has spent millions of dollars "on addiction treatment and other programs aimed at curbing the crisis" of opioid addiction.
"Our jail facilities, our public health facilities, our community treatment centers, our youth treatment centers' resources are all being overburdened and overwhelmed," said Salt Lake County District Attorney Sim Gill during a press conference Tuesday announcing that the lawsuit had been filed.
"And they require a further investment from our community and our tax dollars as we struggle to meet this overwhelming need of (addiction) treatment now for our citizens and into the future. ... The enormous burden on the taxpayers should not — will not — be borne by Salt Lake County's taxpayers alone," Gill continued.
He later added, "what we're really saying is enough is enough."
With the filing, Salt Lake County becomes the third county in Utah to sue pharmaceutical companies this year over of the accusation that manufacturers and marketers of prescription opioids have long deceived the public about the risks inherent in their products.
Summit and Tooele counties have already filed lawsuits, while Utah and Weber counties have also declared they will do the same.
Defendants listed in the lawsuit, some of them under the names of multiple entities that make up different parts of their wide-reaching business operations, include Purdue Pharma, Janssen Pharmaceuticals, Endo Pharmaceuticals, and pharmaceutical companies Allergan and Actavis. Dr. Lynn Webster and Dr. Russell Portenoy are the two named individual defendants in the complaint.
Johnson & Johnson, a parent corporation to Janssen Pharmaceuticals, is also named as a defendant.
Gill wouldn't comment on precisely how much money the county could seek in the lawsuit, except to estimate it would "go into the millions of dollars." Damages received would go toward helping the county fight the opioid crisis using a "therapeutic justice model," he said.
Asked what the strategy is behind the county's decision to file its own lawsuit, Gill responded that "the emphasis here is to recognize this problem has bled down to a local level."
"We have a unique story to tell, that is unique to us," he said. "We couldn't wait for the state. We have the legal authority and independence to (sue)."
Utah Attorney General Reyes said in January that Utah is participating in a 41-state push to negotiate a settlement with opioid makers and is preparing to sue if the terms of an agreement reached in that effort are unsatisfactory.
"Should we feel that at any time during the process leading up to settlement that the manufacturers and distributors aren't cooperating with the states, then we wanted to have the gun loaded, figuratively, ready to pull the trigger on a lawsuit," Reyes told reporters in January.
With only one dissenting vote, lawmakers passed a nonbinding resolution last month that urges Reyes to "immediately and publicly commit to directly filing suit against prescription opioid manufacturers, instead of joining a suit with other plaintiffs, in order to seek the maximum award for damages from prescription opioid manufacturers for the citizens of the state."
House Speaker Greg Hughes, R-Draper, has vocally urged the same of Reyes and of each county statewide

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"Those Were Lies": Salt Lake County Sues Big Pharma For Deceiving the Public

Apr 10, 2018 | KUER (UT)

By Whittney Evans

Salt Lake County has assembled a group of high-profile attorney’s to take on 19 pharmaceutical companies over their role in the opioid crisis.
The county’s legal team includes attorneys who led lawsuits against Big Tobacco and British Petroleum after the Deepwater Horizon oil spill. Former Arizona Attorney General Grant Woods is also on the team.
“Purdue Pharmacy in particular, to name names along with their counterparts went out and persuaded doctors around the United States to persuade the public that these pain pills were not addictive, they were not a big problem and that they were effective for long-term pain. Those were lies,” Woods said.
The complaint filed in Utah’s 3rd District Court also names Johnson and Johnson and Salt Lake City Doctor Lynn Webster among the defendants.
Sheriff Rosie Rivera says nurses at the Salt Lake County Jail spend several hours a day in a quarantine unit, dealing with inmates who are withdrawing from opioids. And it costs the county more than $100,000 a year.
Salt Lake County District Attorney Sim Gill says the county’s disproportionally effected by opioid addiction.
“It is profound, both in terms of the cost in a financial sense, but then you move away from it to the idea of loss in human life and the destruction of emotion and suffering that it’s caused in people’s lives,” Gill said. “It’s incredible.
Officials say at least one Utahn fatally overdoses every day. And nearly half of those deaths occur in Salt Lake County.

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Salt Lake County files suit against opioid manufacturers

Apr 10, 2018 | Good4Utah (UT)

By Glen Mills

Utah's biggest county announced it's joining a growing list of local municipalities who are taking opioid manufacturers to court.
Salt Lake County officials say their area has been hit disproportionately by the opioid epidemic, and they can no longer wait on the state to take action.
About 30 Utahns die every month from an opioid overdose. Nearly half of those happen in Salt Lake County.
That's why the district attorney, mayor and sheriff are teaming up to take action.
They say the epidemic is overwhelming county facilities and services, and costing millions.
"This cost in suffering, the loss of life, the destruction of families, the enormous burden on tax payers should not, will not be borne on Salt Lake County tax payers alone." said DA Sim Gill.
Tuesday morning, the county filed a lawsuit against 19 opioid manufacturers.
The premise is that deceptive marketing led to opioid addiction and overdose deaths.
"Those were lies, and they were lies with tragic consequences. They knew they were lies, but they couldn't turn away from the billions of dollars that they were making," said former Arizona Attorney General Grant Woods.
Woods is part of what Gill calls an “all star legal team.”
A team, that says it can and will win in court.
Mayor Ben McAdams says he's done waiting on Attorney General Sean Reyes to work out a settlement.
"We've waited to see the state step out, and they have not. And so, we were tired of waiting and we felt it was time to move forward. Ultimately, let's hope that we do come to terms with a settlement and we can settle this directly. But, unless you are willing to hold people's feet to the fire, you're not going to get the type of settlement that we want to see," said McAdams.
Summit and Tooele counties have also filed a lawsuit. Utah and Weber counties are preparing to.
Speaker of the House Greg Hughes has been encouraging all Utah counties to get on board.
The attorney general is taking a multi-state approach. He says it could go to a lawsuit, but they are trying to settle first.

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Ben McAdams, Sim Gill announce next step in opioid lawsuit

Apr 10, 2018 | KUTV (UT)

By Tiffany Justice

Another large county is joining the fight against the opioid crisis. Salt Lake County Mayor Ben McAdams, along with District Attorney Sim Gill announced the next step in their lawsuit.
The county filed the lawsuit Tuesday morning against 19 major pharmaceutical companies, including a few individual doctors.
“This is really about advocating on behalf of Salt Lake County and the cost that we’ve taken as tax payers, along with the individual lives that have been destroyed primarily because of a desire from greed from big pharma,” said Sim Gill, Salt Lake County District Attorney.
Utah has the 7th highest rate of drug-related overdose deaths in the nation, and half of those come from Salt Lake County, where leaders are ramping up to do something about it.
According to Sheriff Rosie Rivera, the county spends hundreds of thousands of dollars dealing with overcrowding in jails and inmates dealing with withdrawal.
The lawsuit claims that drug makers downplayed the serious risk of addiction to those who were prescribed pain pills. It further claims that they used “deceptive marketing practices” that “unjustly enriched themselves,” at the counties expense.

Salt Lake county will join Summit County that was the first to file a suit against big pharma and Tooele County.

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Salt Lake County sues Big Pharma over opioid crisis

Apr 10, 2018 | Fox 13 (UT)

By Ben Winslow

County leaders are filing a lawsuit against pharmaceutical giants over the opioid crisis.
At a news conference on Tuesday, Salt Lake County Mayor Ben McAdams, District Attorney Sim Gill and Sheriff Rosie Rivera announced the lawsuit. They accuse pharmaceutical companies of downplaying the risk of addiction to opioids, even as they heavily marketed the drugs to patients.
County leaders alleged drug makers supplied nine out of every 10 Utahns with an opioid prescription. Gill alleged nearly half of all fatal opioid overdoses occurred in Salt Lake County (with 531 reported in 2014-2015).

It’s the latest lawsuit leveled by counties against “Big Pharma.” Summit and Tooele counties have announced lawsuits. Utah County has contemplated one. Utah Attorney General Sean Reyes has been pressured to bring a lawsuit on behalf of the state, but he has told FOX 13 he prefers working with a coalition of 42 other states on a massive piece of litigation.

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Commentary & FYIs

Study: Despite decline in prescriptions, opioid deaths skyrocketing due to heroin and synthetic drugs

Apr 10, 2018 | The Washington Post

By Katie Zezima

Fatalities from heroin and black-market synthetic opioids skyrocketed while the nation saw a decline in the number of opioid painkiller prescriptions and the overdose deaths attributed to them, according to a new study.
The research from the American Action Forum shows that as authorities cracked down on the overprescribing of powerful painkillers, international cartels filled the void with cheap heroin and powerful synthetic opioids such as fentanyl.
The number of opioids prescribed nationwide sharply dropped in 2010, as did the death rate from prescription opioid overdoses. The annual growth rate of deaths involving prescription opioids slowed from 13.4 percent before 2010 to 4.8 percent after. This came after authorities went after pill mills and rogue doctors, states began implementing prescription drug monitoring programs and Purdue Pharma released a reformulated version of the painkiller OxyContin that was more difficult to crush and thus more difficult to abuse, though some users found ways around it.
Deaths involving heroin and fentanyl sharply spiked in the years after. The annual growth rate of heroin deaths surged from 4.1 percent before 2010 to 31.2 percent after; the rate of death from fentanyl use grew from 13.7 percent to 36.5 percent.
Illicit opioids are “filling this void of unmet demand,” said Ben Gitis, who co-authored the study with intern Isabel Soto.
Gitis said many people became dependent on prescription opioids, and when the narcotics became more difficult to obtain, people turned to whatever alternative they could find. The cartels saw that market and filled it rapidly.
“While restrictions on prescription opioids appear to have slowed the growth in overdose fatalities involving those substances, the total number of opioid-involved overdose fatalities has accelerated due to staggering growth in overdose deaths involving heroin and synthetic opioids,” Gitis and Soto wrote.
More than 42,000 people died from an opioid-related overdose in 2016, according to the Centers for Disease Control and Prevention. The increase in deaths from synthetic opioids such as fentanyl has been staggering: From 2013 to 2016, deaths involving these substances grew 84.2 percent each year, according an analysis of CDC data.
Part of the reason for the surge in deaths is many users do not know exactly what drugs they are buying and using, and in some cases they are inadvertently ingesting lethal amounts of synthetic opioids, which include fentanyl and carfentanil, an animal tranquilizer that has killed scores of people. The substances often are cut into heroin or pressed into counterfeit pills that users believe are painkillers or other drugs. The synthetic drugs also are proving to be resistant to overdose-reversing substances such as Narcan.
Gitis believes the study shows that while policymakers need to address the flow of illicit opioids, they must do so while simultaneously tackling the root problem of addiction.
“Say policymakers were to start turning more attention to the supply of illicit opioids, heroin and synthetic opioids, which is obviously something that needs to happen.” Gitis said. “Doing that without addressing dependency could turn users to other types of drugs to use in their addiction.”
He added: “Really, the root cause is the dependency itself.”
The opioid crisis has had a profound effect on the nation’s economy. In a previous study, Gitis and Soto found that nearly 1 million people were not working because of opioid dependency in 2015. The loss of employees and their productivity during that period cost the U.S. economy $702 billion, or just less than $44 billion per year, the study calculated. Employers also have reported they are unable to fill jobs because people cannot pass drug tests.

Hundreds of municipalities around the country are now suing opioid manufacturers, distributors and others up and down the supply chain, claiming they knowingly peddled an addictive product that led to deaths and dependency.

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Major push to combat opioid abuse doesn’t include bill to restore DEA powers

Apr 11, 2018 | Washington Examiner (DC)

By Robert King

Congress is expected to make a major push in the next few months to approve dozens of bipartisan bills to combat the opioid epidemic.
But missing from this effort is a bill to reverse a 2016 law that weakened the Drug Enforcement Administration’s power to go after suspicious drug distributors.
The House Energy and Commerce Committee’s health subcommittee is expected to hold its third legislative hearing on opioid legislation on Wednesday. The committee will consider more than 20 bills that introduce reforms to Medicare and Medicaid to combat the opioid epidemic. On the same day, the Senate Health, Education, Labor and Pensions Committee will hold a hearing on major opioid legislation.
Sen. Claire McCaskill, D-Mo., introduced a bill last year in the Senate to restore DEA powers to fight suspicious drug wholesalers. The bill has been referred to the Senate Judiciary Committee, which means it will not be part of the Senate HELP package.
McCaskill told the Washington Examiner that the bill has not gotten any Republican support.
“I have tried, but so far I have not been able to find anybody who has been willing to cosponsor it, and it is hard to get one across the finish line if you don’t have some Republicans that are willing to help,” McCaskill said.
The bill aims to strengthen DEA enforcement on distributors and wholesalers that give powerful painkillers to corrupt pharmacies called "pill mills. "
The Ensuring Patient Access and Effective Drug Enforcement Act of 2016 weakened that power after extensive lobbying from the pharmaceutical and drug distribution industry, according to an investigation from the Washington Post. The investigation forced Rep. Tom Marino, R-Pa., a major proponent of the legislation, to withdraw his name as nominee to become President Trump’s drug czar.
McCaskill said back in November that she wants to undo the damage done by the 2016 law that was passed by Congress and signed by former President Barack Obama.
The bill will also not be included in the collection of more than 40 bills being considered before the House Energy and Commerce Committee.
“We continue to work with DEA regarding possible legislative changes,” a House aide told the Washington Examiner. “It’s imperative we get this policy right, and we are doing our due diligence.”
The bills aim to focus on different facets of fighting the opioid epidemic, from treatment to enforcement tools. The legislative hearing on Wednesday will focus on legislation that aims to introduce reforms to Medicare and Medicaid to better curb opioid overprescribing and abuse.
Energy and Commerce leadership hope to get the bills through the House before the Memorial Day recess, while no timetable has been set yet for the Senate legislation.
The Senate HELP legislation intends to introduce reforms that include incentives to develop nonaddictive painkillers. It also aims to clarify Food and Drug Administration authority to require manufacturers to give simple and safe options to dispose of unused opioids.
It would also update DEA regulations to improve treatment access for people in rural areas, chiefly through telemedicine.
When asked about why her legislation was not included in this major legislative effort, McCaskill responded, "It's really fascinating, isn't it? I don't get it."

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Congress searches for prescription to help fight growing opioid epidemic

Apr 11, 2018 | USA Today

By Michael Collins

The opioids epidemic that is ripping apart lives across the country appears to be uniting Republicans and Democrats in Congress.
“I know of no other issue right now that commands the attention of so many members of Congress, Republicans and Democrats,” said Sen. Lamar Alexander, a Tennessee Republican who chairs the Senate committee that oversees health care issues.
Four committees in the House and the Senate are holding hearings Wednesday on an assortment of bills looking at different ways to combat the epidemic, which resulted in more than 42,000 opioid overdose deaths in 2016 and which experts agree is growing worse.
Alexander is pushing for his committee to send a bipartisan opioids package to the Senate floor by the end of the month. The goal in the House is to pass a sweeping opioids bill by Memorial Day.
Many of the same proposals are under consideration in both the House and the Senate, increasing the likelihood that some legislation will eventually become law.
In the Senate, the most sweeping proposal is a draft bipartisan bill before the Senate Education, Labor and Pensions Committee. The bill was drafted by the panel’s top two lawmakers – Alexander, who is the chairman, and Washington Sen. Patty Murray, the committee’s top Democrat. The two senators have a track record of championing bipartisan legislation on complex issues.
Their latest proposal, which will be the focus of one of the hearings Wednesday, includes more than a dozen prescriptions for fixing the opioids crisis, including speeding up the development of non-addictive painkillers, stepping up enforcement efforts to stop the flow of addictive drugs from other countries, and sending more grant money into states that have been hit hardest by the epidemic.
“Listening to families and experts across the country who are fighting the opioid epidemic, I’ve heard firsthand about the challenges and opportunities, the successes and failures, the hope and the heartbreak of this crisis,” Murray said. “I’m glad we were able to work in a bipartisan way on legislation that incorporates good ideas from both sides of the aisle to address some of the concerns we’ve heard.
“This bill is a testament to the value of listening and builds on our past efforts with strong new steps to help communities turn the tide.”
Alexander saw the devastating consequences of opioid addiction when he visited a children’s hospital in East Tennessee last week. Ten of the 30 newborns in the neonatal unit were suffering withdrawal symptoms from exposure to opioids, he said, and other hospitals around the state have reported similarly alarming numbers.
“Despite the fact that everybody is working hard to deal with the epidemic, it’s getting worse,” Alexander said. “I expect our response in the Senate to be prompt, urgent and bipartisan.”
The push for development of a non-addictive painkiller may be the most important tool in fighting the epidemic, Alexander said.
Dr. Francis Collins, director of the National Institutes of Health, has predicted that such medication could be ready within five years. Alexander's and Murray's bill would give him the authority to use some of the agency’s existing funds to work with the private sector on research for such drugs and would give the Food and Drug Administration the authority to fast-track the medication and other treatments once they are available.
“So many people live with pain,” Alexander said, “if we can find new truly non-addictive pain medicine or pain strategies, that would bring great relief to millions of Americans and would help solve this epidemic.”
In addition, the Senate proposal would clarify the FDA’s authority to require drug manufacturers to package opioids and other drugs in smaller packs, such as a three- or seven-day supply, and to require that packaging to include simple and safe options for patients to dispose of unused drugs.
The bill also includes provisions that would address the impact of opioids on infants, children and families; enable states to improve their prescription drug monitoring programs and share the data with other states so doctors and pharmacies can know if their patients have a history of substance abuse; and make it easier for medical providers to electronically prescribe controlled substances in limited circumstances.
Meanwhile, a House Energy and Commerce Committee subcommittee reviewed nearly three dozen opioid bills last month and is scheduled to consider another 30 during a hearing on Wednesday.
Hearings also are set Wednesday before subcommittees of the Senate Judiciary Committee and the House Oversight and Government Reform Committee.
The Senate hearing will look at ways to combat fentanyl, a synthetic opioid that is 50 times more potent than heroin and often arrives in the United States via mail from Mexico and China. Fentanyl is blamed for much of the spike in opioid overdoses.
The House panel will review what states and local governments are doing to fight the opioid epidemic and will examine what the federal government can do to help them.

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Doctors bristle at push for opioid prescription limits

Apr 11, 2018 | The Hill

By Rachel Roubein

An increasing number of states and entities in the health industry are putting curbs on the amount of opioids that doctors can prescribe, a controversial move aimed at combating the opioid crisis.
These limits have garnered support from various stakeholders and are now being considered in Congress, with a bipartisan group of senators proposing to set a cap on first-time prescriptions for acute pain.
But the opioid limits have sparked opposition from the American Medical Association (AMA), the powerful group of physicians. It warns that the opioid rules are arbitrary and inhibit a doctor’s ability to care for their patients on an individual basis.
The AMA “supports and encourages judicious prescribing of opioids,” said Dr. Patrice Harris, chairwoman of the association’s opioid task force. But the AMA has “grave concerns” about limits on both dosage and supply.
“Pain is a complex, biopsychosocial phenomenon, and individuals experience pain in different ways,” Harris said. “The AMA believes that decisions around dosages needs to be left between the patient and the physician.”
Supporters of the opioid limits argue the measures are important to curb overprescribing, stem the volume of painkillers that could be diverted for illicit use and decrease a patient’s potential to develop an addiction.
Congress, the administration and state governments are all searching for ways to address the opioid epidemic, which is killing thousands of people per year and has shown no signs of slowing down.
But some doctors are wary of strict mandates, fearing they will get in the way of proper patient treatment.
“Most people think, and I agree, that excess prescribing of opioids was at least one major contributor to today’s tragedy. And so the instinct that we need to continue a course correction of a serious nature is well placed,” said Dr. Stefan Kertesz, professor of medicine at the University of Alabama Birmingham School of Medicine.
“The question is, when is that course correction best enforced as a matter of governmental mandates, and when is that course correction best advanced through a combination of state-based educational and regulatory initiatives that might fall short of hard and fast legislation,” Kertesz said.
Momentum has built behind imposing limits on opioid prescriptions.
In early 2016, Massachusetts became the first state to establish such a restriction, setting a seven-day supply limit for first-time opioid prescriptions. By the end of the year, seven states had passed some type of limit.
As of early April 2018, 28 states have an opioid prescribing limit, guidance or requirement on the books, according to the National Conference of State Legislatures.
Many of the laws cap the supply of first-time opioid prescriptions, such as three or seven days. In a few instances, states have moved to set limits on opioid dosage, placing restrictions on milligrams of morphine per day.
“I think that these policies are an important part of a comprehensive solution to address the opioid crisis,” said Dr. Caleb Alexander, the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness.
But Alexander cautioned that “no single policy is a magic bullet” and that prescription limits should be accompanied with other measures, such as improving care for those in pain and treating those with an opioid addiction.
While Congress hasn’t acted to create opioid restrictions, the Centers for Disease Control and Prevention (CDC) did issue nonbinding guidelines to doctors in 2016. When opioids are used for acute pain, the CDC says, a prescription of three days or less “will often be sufficient” and “more than seven days will rarely be needed.”
Restrictions on the supply of opioids have some powerful backers.
In September, the Pharmaceutical Research and Manufacturers of America announced its support for limiting a patient’s supply of opioids to seven days for first-time acute pain treatment. The lobby group also supports a 30-day supply limit on opioids for chronic pain treatment.
Some private insurers, pharmacy benefit managers and pharmacies have already imposed some limits, such as pharmacy benefit managers CVS Caremark and Cigna.
Late last month, the American Dental Association (ADA) said it wants to put a seven-day limit on dentists’ opioid prescriptions for acute pain. The group’s president, Dr. Joseph Crowley, said that most of the time, dentists’ patients aren’t facing long-term, chronic pain — and that often over-the-counter products are “as effective or more effective” than opioids to solve acute pain.
It makes sense that the ADA’s and AMA’s guidelines are different, Crowley said, because dentists and doctors deal with different patient needs.
Dr. Andrew Kolodny questioned the effectiveness of limits on prescriptions, noting that seven and even three-day prescriptions still come with a lot of pills.
“Lawmakers are passing these bills because they all know a story about someone who got 30 pills when they only needed one or two, and so they’re passing these laws,” said Kolodny, the co-director of the Opioid Policy Research Collaborative at Brandeis University.
“But passing a limit based on duration of use — especially seven-day duration of use — is not going to get at that,” he said,
Rather than limiting the supply of opioids, Kolodny said lawmakers should consider measures like requiring a patient to sign a consent form saying they’ve been warned of the risks associated with opioids.
Back on Capitol Hill, lawmakers are considering several opioid measures.
Senate Health Committee leaders released a bipartisan discussion draft last week that asks the Health and Human Services secretary to issue a report on laws regulating the length, quantity and dosage of opioid prescriptions.
At least one bipartisan group of eight lawmakers proposed a three-day limit on first-time prescriptions for acute pain. This provision was included in a follow-up bill to the Comprehensive Addiction and Recovery Act, dubbed “CARA 2.0,” which was introduced in late February.
The measure has received pushback, but the senators aren’t backing down.
Sen. Rob Portman (R-Ohio) — a chief sponsor of the bill — said it includes carve outs, such as exceptions for those with chronic pain and cancer, meant to address concerns of medical providers.
“After three days, someone can go back to the doctor and renew the prescription if it’s legitimate, but there should be a process there to do that,” Portman told The Hill.
“I just am tired of talking to families who have gone through this, whose kids — or not only kids, sometimes it’s adults who are overprescribed — became addicted and their lives were forever changed because of it,” he said.

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Portland VA study says that patients have same long-term pain with or without opioids

Apr 11, 2018 | OregonLive (OR)

By Molly Harbarger

Patients who swap opioids for other therapies might not experience much difference with chronic pain, according to a new study from a Portland researcher.
Travis Lovejoy, an assistant professor of psychiatry in the OHSU School of Medicine and a clinical psychologist in the VA Portland Health Care System, said the research could help doctors consider different treatments for patients who have been relying on opioids to manage their pain.
"Our hope is our findings may suggest there may be ways to taper or discontinue opioid therapy for patients who might not be the best candidates even if they've been on them for a long time," said Lovejoy, who co-wrote the study with a Washington State University researcher.
Lovejoy will present the study's findings Wednesday to the Society of Behavioral Medicine in New Orleans.
Researchers tracked 600 veterans who'd stopped using opioid medications for one year. They reviewed the medical records of the veterans as they checked in with doctors at regular intervals to learn, on a scale of zero to 10, how much pain the patients experienced. Those rankings were compared with the pain levels they reported while on opioids.
The study found that patients who reduced their opioid intake, or who switched to a non-opioid medication, massage or other therapy, still reported pain – but it was comparable to the levels they reported while relying largely on opioids.
"Our data suggest that patients who discontinue opioid therapy will not experience worse pain," the authors wrote in the study. "Rather, their pain will remain similar or slightly improve, on average, relative to their levels of pain prior to discontinuation."
Addiction to legal and illegal opioids resulted in more than 42,000 overdose deaths in 2016, according to the national Centers for Disease Control and Prevention.
Many U.S. doctors already have backed off prescribing opioid medications or try a mixture of opioids and other medications and therapies. New national guidelines that call for physicians to reduce the reliance on opioids have been effective in bringing down the number of deaths from prescription painkillers. And just last week, the U.S. surgeon general issued a rare nationwide advisory urging Americans to keep the opioid overdose antidote naloxone on hand.
Meanwhile, the number of overdose deaths attributed to heroin and illicit synthetic opioids like fentanyl have increased nationally, according to a research from the U.S. Centers for Disease Control and Drug Prevention.
Lovejoy said the patients who abuse opioids the most have the most to gain from his research.
"The medical community recognizes some of these patients should not be on opioids, but they also might still have chronic pain," Lovejoy said.
Those patients might be able to avoid dangerous behaviors that lead to an overdose by being switched to alternative pain management strategies that aren't addictive.
Lovejoy's research echoes a similar study published in March by a Minneapolis VA doctor, Erin Krebs. That study followed patients who were randomly chosen to receive opioid and non-opioid painkillers. She came to the same conclusion -- there is no significant difference between their outcomes, but one has many more risky side effects.
The research has its limitations -- many patients have compounding issues outside of pain management that might complicate withdrawal from opioid use.
"While there is a current push for policy change and legislation regarding opioids, we still don't fully understand the impact of taking patients off of long-term opioid therapy for treating chronic pain," said lead author Sterling McPherson, associate professor and director of biostatistics and clinical trial design at Washington State University Elson S. Floyd College of Medicine.

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Will Surgeon General’s Opioid Overdose Plan Make a Dent in Drug Crisis? (Opinion)

Apr 10, 2018 | Healthline

By Daivd Mills

“First, do no harm” is one of the promises most medical students make as they become doctors.
In that sense, the plan laid out last week by the U.S. surgeon general involving opioid overdose antidotes fits the bill.
However, whether that proposal is practical and whether it’ll even make a dent in the nation’s opioid epidemic is a matter of debate.
Last Thursday, Dr. Jerome Adams issued a national advisory urging a large portion of the nation’s population to carry with them overdose antidotes containing the drug naloxone.
The targeted groups include people who take prescribed opioids for pain and those who are misusing prescription drugs and illicit opioids, as well as their family members and friends.
It was the first national advisory issued by a surgeon general since 2005, when pregnant women were urged not to drink alcohol.
In his advisory, Adams urged patients and the public to learn the symptoms of an opioid overdose and to be trained in how to administer naloxone.
Adams also urged physicians, pharmacists, and other medical providers to learn to identify people who are at high risk of opioid overdoses and then prescribe or dispense the antidote drug to them.
“You have an important role to play in addressing this public health crisis,” Adams told both patients and the public.
In his message, Adams cited statistics from the Centers for Disease Control and Prevention that show that more than 42,000 people in the United States died from opioid overdoses in 2016, up from 21,000 in 2010.
About 40 percent of those deaths were from prescription opioids, while the others involved illicit opioids such as heroin and fentanyl.
Adams also pointed out that 77 percent of opioid overdoses happen outside of medical facilities. More than half occur at home.
Experts in the medical community say the surgeon general’s initiative certainly can’t hurt. First and foremost, naloxone is a safe drug that’s relatively easy to use. Without a doubt, it saves lives.
“Surgeon General Adams, physicians, first responders and public health advocates all recognize that naloxone is a literal lifesaver and a vital tool in our fight against the opioid epidemic,” said Dr. Patrice Harris, MA, chair of the American Medical Association Opioid Task Force, in a statement sent to Healthline. “Patients, family members and friends should not hesitate to ask their physicians to prescribe naloxone so they can save their own or their loved one’s lives.”
“It’s nice to see the surgeon general come up with this very important policy,” added Jon Zibbell, a senior public health analyst in the behavioral and urban health program at RTI International research foundation in Washington, D.C. “It’s something you can look at as a public health crisis that can affect anybody.”
Dr. Caleb Alexander, the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, says the campaign, if nothing else, can educate people.
“Advocacy raises awareness. It plays an important role,” he told Healthline.
However, Alexander said reducing the number of opioid prescriptions and getting people who are addicted to the drugs into treatment programs are more effective tools.
“There are no magic bullets,” he said. “We shouldn’t rely on naloxone to get us out of this mess.”
“It’s a good step in the right direction,” added Dr. Indra Cidambi, an addiction medicine specialist and the medical director at the Center for Network Therapy in New Jersey. “But what happens [after administering naloxone] is the most important.”Two antidotes available
There are two naloxone-based drugs approved by the U.S. Food and Drug Administration for the general public to use to try to reverse the effects of an opioid overdose.
The best-known and most commonly used is Narcan. It’s a nasal spray manufactured by Adapt Pharma.
The other is Evzio, an auto-injector manufactured by Kaleo Inc.
Within hours of the surgeon general’s advisory, Adapt Pharma sent out a press releaseannouncing a strengthened partnership with CVS Health, Walgreens, and Harvard Pilgrim to improve access to Narcan.
The antidote is already available at CVS stores in 49 states without a prescription.
“We’re very encouraged by the proposal,” Mike Kelly, Adapt’s president of U.S. operations, told Healthline. “It’s something we’ve been trying to get people to do.”
Kaleo executives also sent out a press release the day the plan was revealed. Among other things, the company announced a new initiative to expand access for the public to Evzio.
The initiative is a “virtual standing order” where residents of six states (California, Arizona, Colorado, Missouri, Nevada, and Ohio) can obtain Evzio for no cost and without a prescription by calling a toll-free number.
This is in addition to the company’s current program called EVZIO2YOU, where people in the United States with commercial insurance and a prescription can get Evzio at no cost.
“The surgeon general’s call to action is a bold and necessary move to encourage everyone to learn about the signs and symptoms of an opioid overdose and arm themselves with potentially lifesaving naloxone,” a Kaleo representative told Healthline in an email.
If the public heeds the recommendations by the surgeon general, both Adapt and Kaleo would likely reap a financial windfall.
However, representatives from both companies say the initiatives are about more than just sales and profits.
“We don’t view this as a windfall. We view this as an obligation,” Kelly said. “We believe in broad awareness and broad access.”
“Our commitment to expand access to Evzio is about ensuring that patients who need naloxone can get it,” the Kaleo representative added. “And these new initiatives are in line with our ongoing commitment to patients and affordability.”
Kelly said officials in the surgeon general’s office had been in contact with Adapt executives to garner input for the proposal. He said the company was aware of the antidote plan a few days before it was announced.
Kaleo representatives said they also met with various administration officials to provide input.How would this work?
Virtually everyone agrees that Narcan and Evzio saves lives.
In fact, the city of San Francisco has been educating the public and organizations about Narcan since 2003.
The city has also formed partnerships with community organizations and has trained more than 10,000 people on how to recognize an overdose and then administer Narcan.
The city also makes the antidote available for free at more than 15 locations.
As a result, San Francisco has one of the lowest fatal overdose rates in the United States.
The big question is whether this approach can work on a nationwide basis.
There are a number of issues surrounding the surgeon general’s proposal.
Among them is the practicality of getting millions of people to carry an overdose antidote.
Zibbell told Healthline there are two groups to target.
The first is the people who misuse prescription and illicit opioids as well as their family members, friends, and people they encounter in daily life.
The second is members of the general public who are willing to assist someone who is overdosing.
“There is evidence that it is really effective when you get naloxone into the hands of lay people,” Zibbell said. “Make it so anybody who wants it can get it.”
No one disputes that Narcan and Evzio are safe.
Narcan is a nasal spray that’s pretty easy to use. Evzio is an injector that has voice commands that walk a rescuer through each step.
Experts also told Healthline that giving an antidote to someone who isn’t overdosing won’t harm them.
They also said there are no health dangers if a child or someone else accidentally uses the antidote on themselves.
“Narcan is safe and effective,” said Alexander.
Dr. Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), agrees.
“If you were (accidentally) injected with the drug, you’d feel nothing,” she told Healthline.Will it make a difference?
Even if most everybody carries an antidote and uses it properly, there’s some debate over whether the surgeon general’s plan would have a measurable impact on the opioid crisis.
For starters, there are those who say antidotes such as Narcan and Evzio actually set back efforts to reduce opioid use disorders.
Their argument is that people with an opioid addiction might not enter treatment programs if they figure they’re going to be saved if they overdose.
That contention as well as other reasons prompted a sheriff in Ohio to tell his deputies last summer to stop carrying Narcan.
In another part of Ohio, a city council representative said police in his town shouldn’t respond to a home if the emergency involved a third overdose by the same person.
Alexander finds these theories to be illogical.
“That makes about as much sense as taking away seat belts and air bags from people who drive too fast,” he said.
Zibbell agrees, saying these contentions aren’t based in fact.
“When people don’t go into treatment, it’s not because of naloxone,” he said.
Zibbell, in fact, says people with opioid use disorders don’t like naloxone. When they awake from treatment, they feel ill and actually go through withdrawal symptoms because of the way the drug works.
“People don’t want it. It really should be used only as a last resort,” he said.
Cidambi notes that when people are revived and taken to a medical facility is a crucial time to try to get them into treatment programs.
“If there’s no support system, then you are setting them up. Then, they go looking for the drug,” she told Healthline. “We should be focusing more on treatment.”
Volkow is in agreement.
“When you are given naloxone, you feel awful because you go into withdrawal,” she explained. “That person will go out and seek drugs.”
“You have to do everything you can to steer them into treatment,” she added. “That time is a unique opportunity to engage them.”
Alexander agrees the focus should be on reducing the number of opioid prescriptions in the country and convincing people with opioid addictions to get into treatment programs.
“At the end of the day, opioid use disorder is a chronic disease,” he said. “Patients need access to good treatment.”
Kelly said Adapt executives agree that the antidote is only part of the solution.
“Narcan is not the solution to the opioid epidemic. It’s only part of the solution,” he said. “The first priority, though, is to save lives.”
Kelly said antidotes like Narcan can be a “bridge” between someone overdosing and getting into treatment.
Zibbell agrees that a multipronged approach is needed. But first, he notes, you have to save people’s lives.
“The first we need to do is keep people from dying so they can make choices afterward,” he said.
Zibbell also believes the country can focus on antidotes, treatment, and prescriptions at the same time.
“We can do multiple things on this all at once,” he said.

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Other Views: Opioids Lawsuit Makes Sense, Just as Tobacco Suits Did (Opinion)

Apr 10, 2018 | The Chronicle (WA)

By Editorial Board

Thurston County commissioners made a good call recently to join other Washington counties and cities in a federal lawsuit against the makers of opioids.
There is evidence some of the largest pharmaceutical firms downplayed the addiction risks that go hand in hand with use of certain painkillers.
The lawsuit, like the national tobacco lawsuits that earned hundreds of billions of dollars for states in the 1990s, seeks to reimburse local governments for the costs incurred as a result of the opioid addiction “epidemic,” as Thurston County Prosecuting Attorney Jon Tunheim puts it.
How much damage Thurston County has actually suffered remains to be calculated, according to Scott Cushing, a senior deputy in the county prosecutor’s civil department.
The federal complaint was filed on behalf of the county by a Seattle law firm. The county alleges that at least 106 Thurston County residents died of opioid-related overdoses during 2012-16. This led county public health director Schelli Slaughter to call opioid addiction a public health emergency.
The lawsuit’s cost and risk for county taxpayers appears small. Thurston County entered into a contingency fee agreement with Keller Rohrback L.L.P. of Seattle that will pay the law firm roughly $1 of every $5 recovered in the suit, depending on the amount won, if any.
Keller Rohrback has filed the lawsuit under the state consumer protection law and federal racketeering statutes on behalf of other local governments including King, Pierce and Skagit counties and the cities of Tacoma, Mount Vernon, Burlington and Sedro-Woolley. The Washington attorney general also is pursuing a case.
Thurston County’s lawsuit was transferred this week to the growing portfolio of opioids cases handled by a federal judge in northern Ohio. That Ohio court is handling a consolidation of potentially hundreds of cases nationwide. Also transferred was a claim by the Nisqually Tribe near Yelm.
The targeted parties include OxyContin maker Purdue Pharma, Percocet maker Endo Pharmaceuticals, and Janssen Pharmaceuticals, the Johnson & Johnson subsidiary that makes patches that release fentanyl, and other manufacturers. The top distributors of opioids including Ohio-based Cardinal Health also are named as defendants, based on an allegation that dangerous drugs were marketed aggressively without adequate warnings of risks.
The moves to counter opioids in court may be new but the ravages of opioid addiction are not. Some experts trace the current addiction crisis to the development of new, highly addictive painkillers that became available in the 1990s.
But while the ground is moving on the national opioids crisis, it would be a shame if the only real progress occurred locally or in courts.
President Trump last month encouraged a federal lawsuit along similar lines. However, Trump and GOP allies have sought to undercut the Affordable Care Act’s expansion of Medicaid, which allowed some states like Ohio and its Republican governor, John Kasich, to expand treatment to more destitute addicts.
Despite heavy lobbying outlays by the drug industry, prescribing practices have been reined in by states like Washington. These prescribing protocols may reduce the number of new addicts.
But as prescribed pain drugs have become unavailable or unaffordable for users, addicts are turning to cheaper heroin, a cousin drug made from opium, and dealers are sometimes cutting heroin with the deadly fentanyl. This is driving some of the death toll.
Slaughter says half of those using clean-needle programs in Thurston County are using heroin.
The answer is not to withhold clean needles or leave addicts for dead in city alleys or door stoops, but to ensure there are pathways for drug-dependent residents to find sobriety.
The lawsuit does not provide that pathway, but it is a welcome piece in the larger fight to reclaim our loved ones, neighbors and even strangers on the street who cannot kick these most potent of addictions.

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Southeast (FL, TN, GA)

County approves new lawsuit against Big Pharma

Apr 10, 2018 | Osceola News Gazette (FL)

By Rachel Christian

Local government approved another legal measure Monday aimed at combating the opioid crisis in Osceola County.
County commissioners green-lighted an Opioid Cost Recovery and Public Nuisance ordinance this week that makes powerful claims about the deadly and costly impact opioid addiction is having on the community.
What the lawsuit claims
The measure asserts that the distribution and sale of powerful prescription narcotic pain medications has created a “public safety hazard” that’s led to “significant” healthcare, family and social services, criminal justice and rehabilitation program costs for the county.
The local legislation allows the county to retroactively recover damages from “the responsible party” through legal or criminal action, along with “attorney’s fees, interest and any other payment or damages the court decrees proper.”
But County Attorney Andrew Mai said the ordinance is aimed less at the individuals who may sell or buy the drugs, and more at the corporations that manufacture and profit from addictive opioids.
Language in Monday’s measure shares similarities with a groundbreaking lawsuit the county filed against more than 20 Big Pharma companies earlier this year, including the maker of OxyContin and corporations like Johnson & Johnson.
Mai said the ordinance and lawsuit are meant to hold large companies accountable for costs incurred by the county due to recent spikes in opioid abuse and overdoses among residents.
The first in Florida, but a growing trend
Osceola became the first county in Florida to file such a suit against pharmaceutical companies for this reason.
New York-based law firm Napoli Shkolnik signed professional service contracts with Osceola County in November, along with more than 100 other municipalities nationwide that are undergoing similar litigation cases.
Napoli Shkolnik is taking the case on for free due to a contingency clause, but if the firm wins the case, it stands to receive 25 percent of total damages awarded.
The suit, currently in circuit court, asserts claims including that drug companies put their desires for making money above the well-being of consumers by using a deceptive and unfair marketing campaign to get doctors and patients to use the powerful drugs to treat chronic pain long-term, rather than short-term, as was originally intended.
Mai said it is still being determined how much money the county stands to gain if they emerge as victors in the upcoming legal battle.
Legal precedence?
This isn’t the first time Osceola County has taken major legal action against big-name corporations.
About 10 years ago, Mai said the local government entered a suit against several large online travel websites, including Expedia and Orbitz.
The county claimed that the defending companies weren’t paying a fair share of tourism development taxes, though the website’s business models profited from site visitors who spent tourism dollars in Osceola County.
A nearly identical suit ended up before the Supreme Court, but the county ultimately lost its case when the country’s highest court ruled in favor of the online travel companies.
Because it included the same kind of contingency clause as the new opioid lawsuit, Osceola County didn’t lose money in the case 10 years ago, but it didn’t walk away with anything, either.
Mai said he’s more confident in the new opioid case then he was in the tourism tax suit, which tended to be more subjective and less fact-driven.
How long will it all take?
Litigation is not a speedy process, Mai said, and he anticipates the ordeal to last anywhere from three to ten years, depending on if it goes to trial or settles out of court.
If the county wins the suit, the money left over after attorney fees will be deposed into the county’s General Fund, Mai said.
County commissioners will then be responsible for how that money is spent.
“It would then be up to them to decide what would be the appropriate use for that money, whether it would go toward potential treatment centers, the cost of the jail, or more law enforcement,” Mai said.
Latest federal, state responses to opioid crisis
Responses to the opioid crisis are taking place at all levels of government.
Last month, President Donald Trump signed a spending plan that included $4.6 billion to fight the national opioid crisis. It was one of the few inclusions on the total $1.3 trillion budget appropriation that received bi-partisan support.
State lawmakers also weighed in on the issue during the recent legislative session.
A new law signed by Gov. Rick Scott in March sets aside about $53 million, in addition to funds in the budget signed last month, which brings the total to about $65 million, for enhanced opioid treatment, law enforcement response and supply a life-saving overdose reversal drug to overdose victims via first responders.

The new law serves as Florida’s first piece of legislation to address the opioid epidemic.

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City of St. Augustine notebook: Commission allows demo of Echo House

Apr 11, 2018 | The St. Augustine Record (FL)

By Sheldon Gardner

St. Augustine commissioners tackled a number of topics on Monday night. Here are some highlights:
• Commissioners voted 3-2 to allow demolition of Echo House, a nearly century-old building in Lincolnville. The property used to be a community center and a nursing home for African-Americans who needed care.
The property owner, St. Paul AME Church, had already received approval by the city’s Historic Architectural Review Board to demolish what’s left of the building. The board’s stipulation was that the church would wait 10 months to allow the community to come up with a solution. As of Monday, the church can get a demolition permit.
In a last-minute attempt to save the building, the city negotiated with church officials, but those negotiations fell through. Commissioners discussed possibly telling city staff not to issue a demolition permit — which would possibly launch the city into litigation with the church — but the majority voted against stopping the demolition. Commissioners Leanna Freeman and Nancy Sikes-Kline dissented.
• Commissioners voted to accept a $750,000 Florida Department of Economic Opportunity Community Development Block Grant for a Lincolnville drainage project.
• Commissioners discussed the possibility of suing pharmaceutical companies in response to the opioid crisis, something that is happening in other areas. But they didn’t make a decision on Monday. City officials plan to provide details about the cost of the crisis on St. Augustine at the next Commission meeting.
• Police Chief Barry Fox recommended the City Commission wait until new case law unfolds before making decisions on how to address internet cafes in the city. The cafes are typically adult gaming establishments, and across the state questions have been raised about their legality.
•The city accepted checks of $300,000 and $100,000 from the Florida Inland Navigation District and the St. Augustine Port, Waterway & Beach District for dredging Salt Run, a regularly occurring project.
• The city’s auditor, Gary Huggett, of Masters, Smith & Wisby, described the city’s Comprehensive Annual Financial report for the fiscal year ending Sept. 30, 2017. The nearly 200-page report includes a letter from the auditor with recommendations for better financial management.
The audit found that the city’s closing of books and records was delayed, and adjustments were still needed at the time of the audit, according to the letter. The audit also found that the city hadn’t properly accounted for several payments to construction contractors at the end of the year, according to the letter. The city committed to taking the steps to prevent such errors in the future.

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Suing Big Pharma

Apr 10, 2018 | Citizen Tribune (TN)

By Staff

Appetites whetted by the multi-billion dollar settlement with Big Tobacco 20 years ago, counties across the nation are suing Big Pharma to recover costs associated with the opioid epidemic. But in Tennessee, Attorney General Herbert Slatery doesn’t want just a piece of that pie, but all of it.
Slatery, recently selected by a coalition of 40 states to spearhead their yet-to-be-filed suit, is attempting to shut down similar suits by counties, including one last year filed by Sullivan, Hawkins and Washington counties. It’s a money grab and the counties should fight it tooth and nail.
County district attorneys say Slatery sat by as the opioid epidemic decimated their communities and since that’s where the damage was done, that’s where any legal awards should go. It’s been nine months since the local suit was filed and now that he’s in charge of the national lawsuit where states will get any gravy, he wants local suits out of the way.
Slatery has filed a motion to intervene in the county suits, arguing that they don’t have authority to sue drug manufacturers, which of course, they do. He whines that the suits have been brought by the counties “on behalf of the state,” which they have not. And he claims counties may not obligate the state for the cost of outside counsel, which the counties are not. Assisting the local lawsuit is a Nashville firm which isn’t getting a dime. They only collect if the suit is successful.
The group of 40 states that Slatery is leading has not filed any suit against Big Pharma. Instead, it is negotiating in lieu of a suit. The counties which are bearing the brunt of the cost of the opioid epidemic are not party to those settlement discussions and if they lead to a settlement, would only be in line for whatever crumbs the state may sweep their way.
“We want to work with the attorney general,” said Sullivan District Attorney General Barry Staubus. “However, I believe that I have the authority to file this suit and this is the most effective way to seek redress through the courts — with our lawsuit in our county, where we live and where we reside and we see the problem. Not in Nashville.”
Says Slatery, “The office of the attorney general is in the best position both to represent the interests of the state and to obtain the best possible monetary recovery for key governmental stakeholders.” But as we’ve seen, the interests of the state and its counties may not coincide.
A 2007 settlement of 26 states and Washington, D.C., against Purdue Pharma yielded $19.5 million with Tennessee getting pennies on the on the dollar. Tennessee received $400,000 for attorney fees for the district attorney’s office, $175,750 for the state general fund, and $143,750 for consumer education projects to fund further investigations or litigation at the attorney general’s discretion.

Counties repeatedly asked Slatery to work with them, but his office would only say it was investigating the possibility of suing Big Pharma. In the wake of that intransigence, the counties acted on their own, as they should have. Slatery needs to step aside. His intentions are not what’s best for our local counties, nor for the state of Tennessee.

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Catoosa County Takes on Drugmakers With Opioid Lawsuit

Apr 10, 2018 | Law.com

By Katheryn Tucker

A small county in Northwest Georgia has joined the litigation battle against makers and sellers of opioid drugs.
Catoosa County near the Tennessee and Alabama state lines has filed a lawsuit against multiple defendants in federal court seeking damages for economic losses as a result of the opioid addiction crisis.
Catoosa County is represented by Beasley Allen lawyers Rhon E. Jones, who is head of the firm’s Toxic Torts Section, Rick Stratton, Jeff Price, Will Sutton and Ryan Kral, along with local county attorneys Clifton M. “Skip” Patty, Jr. and C. Chad Young of Patty & Young Attorneys at Law in Ringgold.
The complaint is filed in the U.S. District Court for the Northern District of Georgia, Rome Division.
Beasley Allen has filed similar lawsuits on behalf of a number of Alabama municipalities, as well as Sumner County, Tennessee. The firm also is representing the State of Alabama in its opioid lawsuit against Purdue Pharmaceuticals.
Purdue shared this statement:
“We are deeply troubled by the opioid 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. Although our products account for approximately 2% of the total opioid prescriptions, as a company, we’ve distributed the CDC Guideline for Prescribing Opioids for Chronic Pain, developed the first FDA-approved opioid medication with abuse-deterrent properties and partner with law enforcement to ensure access to naloxone. We vigorously deny these allegations and look forward to the opportunity to present our defense.”
Beasley Allen’s Jones said in a news release Tuesday that the pharmaceutical industry deceived the American public when it flooded the market with highly addictive opioids.
“The industry’s unrestrained greed created an opioid epidemic that continues to unfold across the nation. Local resources have been stretched beyond many local governments’ limits, costing them a total of $504 billion dollars annually as they fight the complex and multifaceted problems that accompany opioid addiction,” Jones said.
“Catoosa County has been held in opioid’s tight grip, draining our local resources all because of the pharmaceutical industry’s greed,” Young said. “We want the industry to know that you cannot hide any longer. It is time that you pay for ripping apart families and communities and for leveraging your untold fortune on the backs or hard-working taxpayers.”
“Thanks to Big Pharma, between 1999 and 2014, prescription opioid deaths increased tenfold in Georgia,” Patty said in the Beasley Allen news release. “It has landed us as the 11th state in the country for the most prescription opioid overdoses. Local governments have triaged the victims and have begun to rebuild after the opioid epidemic took their communities by storm. Now they are seeking justice and reparation from those responsible for the epidemic.”
Economic damages resulting from the opioid epidemic include costs for providing medical care, therapeutic care and treatments for patients suffering from opioid-related addiction or disease, including overdoses and deaths; costs for providing counseling and rehabilitation services; costs for treating infants born with opioid-related medical conditions; public safety and law enforcement expenses; and care for children whose parents suffer from opioid-related disability or incapacitation, the lawyers said.
In 2016, Catoosa County had an opioid prescription rate of 116.1 for every 100 people. Nationally, opioids are responsible for killing more than 183,000 people since 1999, the lawyers said, quoting the Centers for Disease Control and Prevention. In 2016 alone, 42,000 people in the U.S. died from opioid overdoses.

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Lawmakers lament lack of opioid legislation

Apr 10, 2018 | Valdosta Daily Times (GA)

By Jill Nolin

Two key state legislators lamented the recent failure of measures aimed at curbing the opioid crisis in Georgia at a task force meeting held Monday.
Sen. Renee Unterman and Rep. Sharon Cooper – who both chair their respective chamber’s health and human services committee – each publicly expressed disappointment after opioid-related bills stalled during the just-ended legislative session.
“You would think it would just fly through,” Unterman, R-Buford, said of her bill Monday while speaking to members of an opioid task force formed last year by Attorney General Chris Carr.
“It would just breeze on through, because you’ve got mothers and constituents hollering at these senators and these representatives. But it didn’t,” she said. “But I will say that the money we put into the budget is just as important as any law that we can create, that this is a foundation.”
Nearly 1,400 people in Georgia died from a drug overdose in 2016, according to the Centers from Disease Control and Prevention, which points to opioids as the main driver of drug overdose deaths.
Unterman’s proposal would have created a so-called “drug czar” position and formed a commission that would focus on substance abuse while taking a look at Medicaid waivers as an option for boosting treatment services in the state.
It would have also targeted unscrupulous providers who offer financial incentives for referrals or other perks, such as free transportation to a center, while trying to capitalize on those seeking recovery.
The measure passed in the Senate but never made it out of Cooper’s committee.
Cooper, meanwhile, said she was disappointed that a House-endorsed proposal to create a needle-exchange program did not pass this year, adding that “politics took preference to people.”
Such a program would have helped the state get a handle on diseases, such as Hepatitis C, that are often spread when people share needles while injecting drugs. It would have also connected people to counseling and other services, she said.
The bill stalled after Unterman tacked her measure onto it – a common legislative maneuver at the end of the session.
“There’s a little friendly rivalry sometimes between the two chambers, and sometimes it’s not so friendly,” said Cooper, R-Marietta. “We both have our ideas.”
Cooper said Unterman’s plan for a “drug czar” ran into trouble because House leadership thought the decision should be left for the next governor, who will be elected this November. She also said the proposal seemed to duplicate efforts already underway.
Lawmakers did agree to increase funding for opioid-related programs, such as new recovery centers and a program that helps new mothers overcome addiction while caring for a newborn with neonatal abstinence syndrome.

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Midwest (MI, IA, OH)

Jackson considers joining other communities in opioid lawsuit

Apr 10, 2018 | WLNS 6 (MI)

By Aaron Dimick

Communities across the state have spent millions of dollars to battle the opioid crisis. And now they want the drug companies to pay.
Many are coming together for a federal lawsuit that targets drug suppliers.
The city of Jackson could be the next community to join the suit.
Mayor Derek Dobies says the high number of prescription drugs circulating Jackson is causing problems.
"There a lot of opiates in the city. I think it's indicative of the huge problem we have not only in the city, but the state and the nation," Dobies said.
Tuesday night, the Jackson City Council is considering whether the city should join a lawsuit to target drug companies.
Dozens of Michigan communities, including Lansing, are already involved in the lawsuit launched last December by the Sam Bernstein Law Firm.
The lawsuit claims drug makers and pharmacies are playing a major role in the opioid crisis by aggressively pushing addictive drugs and illegally prescribing them.
The communities want drug companies to change prescribing policies, but they're also seeking reimbursement for the high cost of responding to this crisis.
Mayor Dobies says constantly responding to overdoses is a strain for public safety in the city.
"That creates a huge problem for our city to be able to provide for public safety and to be able to respond to basic city services," Dobies said.
Dobies supports the city joining the lawsuit.
Other council members 6 News spoke with said they are still considering it.
The mayor believes joining the lawsuit can make a difference.
"I think this is a big first step and a big line in the sand saying that we're going to take this issue seriously. What the city is trying to do in joining this lawsuit is try to curb that sort of behavior out of the industry itself. Seek injunctive relief and try to recover some of the damages, the cost that we incurred having to respond to the opiate epidemic here at the local level."
Stay with 6 News for updates on the city council's vote.

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City manager appointment, opioid litigation, public comment rules on council agenda

Apr 10, 2018 | Michigan Live (MI)

By Taylor Desormeau

City Manager Patrick Burtch's potential appointment to the Downtown Development Authority, and a new set of council meeting citizen guidelines are among the topics at the next Jackson City Council meeting.
The Tuesday, April 10 meeting starts at 6:30 p.m. on the second floor of Jackson City Hall, 161 W. Michigan Ave.
Burtch has been appointed to the Downtown Development Authority by Mayor Derek Dobies, but that appointment must be voted on by council. It's part of the consent calendar for Tuesday's meeting.
Burtsch also serves on the Brownfield Redevelopment Authority board, the Public Arts Commission, various city pension boards and the Planning Commission.
It's not unprecedented for a city manager to sit on the city's DDA, as cities like Wixom and Alpena have the manager on the board. Some cities have the city manager appoint members instead of the mayor.
Also at Tuesday's meeting, the council will consider entering nationwide opioid litigation to potentially recover funds from pharmaceutical manufacturers, wholesalers and distributors for their role in the opioid epidemic.
A pair of law firms, including the Bernstein Law Firm, presented to the council at the last meeting.
Public comment guidelines, removed from the March 27 agenda, are also back on Tuesday's docket. Go to page 70 to see the list of 14 guidelines.
One change from the previously proposed set is the elimination of the guideline stating: "If an individual's disruptive behavior rises to the level of a criminal offense, the person may be charged with a criminal offense."

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Cerro Gordo County supervisors table opioid resolution recommendation

Apr 10, 2018 | Globe Gazette (IA)

By Steve Bohnel

After a roughly 15-20 minute discussion with Cerro Gordo County Attorney Carlyle Dalen, the Cerro Gordo County Board of Supervisors decided to table a resolution to join a joint lawsuit against out-of-state opioid manufacturers.
The lawsuit is the same one Mitchell County joined earlier this year. Dalen informed the supervisors that Crueger Dickinson, a national lawfirm based in Whitefish, Wisconsin, is leading the joint lawsuit.
Dozens of counties statewide have joined the lawsuit, but so far, Mitchell is the only one within the Globe Gazette's coverage area to join.
Dalen said Crueger Dickinson would hire attorneys, which would then travel to the counties involved in the lawsuit, gather information about any opioid issues in those counties.
Some counties have not decided to join the lawsuit is because there is no benefit to join and others believe they would be "just joining in on ligitation," according to Dalen.
He recommended Cerro Gordo County join the lawsuit, as long as the workload on the county's end wouldn't increase significantly.
"I don't see a huge downside ... what do we have to lose?" Dalen told the supervisors. "As long as we don't have a lot of people working overtime, this is a lawsuit against a bunch of big companies."
All three supervisors asked Dalen multiple questions about the lawsuit, including how many resources the county would need to deploy and what the end result might be.
Dalen said he's unsure of what Crueger Dickinson would actually want, adding that might be why several Iowa counties have decided not to join the joint lawsuit.
"That's the part that scares all of us," he said. "I don't know what that looks like, and that's been part of my reluctance."
Board Chairman Casey Callanan suggested the supervisors table the resolution until Dalen and they could learn more about the issue. Fellow supervisors Tim Latham and Chris Watts seconded that opinion.
"I'm just concerned we're gonna spend a lot of money and not see anything in return," Latham said.
The supervisors acknowledged they could revisit the issue in the next couple of months, as more information is gathered. They then thanked Dalen for his research and presentation, and unianimously voted to table a resolution to join the joint lawsuit.
In other business, the supervisors canvassed the special school election from last Tuesday. Two school levies were renewed with roughly 77 and 78 percent of the vote.
The supervisors also approved that three manure management plans throughout the county be forwarded to the state Department of Natural Resources.

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Council hears presentation on opioid lawsuit

Apr 10, 2018 | The Times-Bulletin (OH)

By Kirsten Barnhart

City Council heard a presentation from lawyer Al Smith regarding opioid litigation. He urged the City to join a lawsuit against pharmaceutical companies for wrong doing.
“It’s kind of startling when you start looking at the facts and the numbers that are already known; every day 150 people in the United States die in a drug overdose,” said Smith. “Of that 150, 60 percent are from some form of opioid medication – narcotic pain medication, principally. The leading cause of death for people under 55 years of age is overdose, which has never happened before.”
The lawsuit has been filed against the manufacturers, whole salers, and distributors of opioid medications.
“There’s clear evidence already that they had knowledge that these drugs were making their way on to the black market, principally aided by them, because they were shipping ridiculous amounts of these drugs to places that never had any actual use for them,” said Smith.
Smith said that joining the suit would be no-risk to the City of Van Wert. A 25 percent contingency fee stands if the suit is successful. If it is not, there is no cost.
Smith urged Council to retain a lawyer as soon as possible if they wish to join because there are statue of limitations at some point that will kick in.
The City Law Director, John Hatcher, noted that he has seen an increase in domestic violence and assaults and a decrease in DUI’s.
“It’s drug related, unfortunately,” said Hatcher. “The police officers have been doing a wonderful job of handling these situations every case when there’s a domestic dispute or assault involved. They seem to go in and handle it pretty well. They do a great job.”
During his report, Mayor Jerry Mazur commended first responders for saving a life during a recent fire and for the hard work they put in every day.
“I think it was very heroic for them to go into a burning building and make every attempt to rescue those that were in there,” said Mazur. “I have a lot of admiration for them and what they do.”
In other business, Council addressed recent complaints about trash haulers picking up residential curbside trash regularly on Saturdays. Council urged any concerned about this issue to take a photo of the trash truck and report it to Bill Lawson or Councilman-At-Large Bill Marshall.
During his report, Safety Service Director Jay Fleming noted that Steve Richardson is retiring after 21 years with the Van Wert Police Department, and that John Motycka was announced as the new Waste Water Superintendent. Motycka comes to the city with roughly 30 years of operational experience and a class four license.
Fleming also stated that brush pick up will begin on May 7.
During her report, City Auditor Martha Balyeat said that after doing a 20-year average on income tax collections she found that the 20-year average for the first quarter is 24 percent. Balyeat said at the end of the current first quarter, the city is on target to hit that 24 percent.
“That’s a good sign,” said Balyeat. “I was hoping it would be more than what we anticipated, but we’re at least on track to collect what we projected.”
Also during the meeting, Council asked the Law Director to prepare legislation to add language that would include properties that devalue neighbors real estate as a nuisance violation.
Council approved a resolution authorizing and directing the Safety Service Director to apply to the Ohio Department of Transportation for the Transportation Alternatives Program funding.
A 15 minute committee meeting was set prior to the next Council meeting to discuss sidewalk ballot language.
The next City Council meeting will be held April 23 at 6:30 p.m. in the Council Chambers of the Municipal Building.

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Northeast (MA, PA)

Easton joins opioid lawsuit

Apr 10, 2018 | Wicked Local (MA)

By Donna Whitehead

The Board of Selectmen voted Monday, April 9, to join the Massachusetts Opioid Litigation Attorneys in suing pharmaceutical companies and distributors to recover municipal costs that have been incurred as a result of the opioid crisis.
Attorney Richard Sandman said MOLA is bringing lawsuits on behalf of cities and towns in Massachusetts to hold them accountable for the opioid crisis and pay for past costs including law enforcement, emergency medical services, Narcan, treatment services, education and prevention. There is also a national litigation effort.
“There were over 42,000 deaths (nationwide) last year,” Sandman said.
In Easton Sandman said there was one opioid overdose death in 2012. In 2013, there were two; seven in 2014; six in 2015; and eight in 2016. He said Easton had at least 21 emergency medical service calls during 2017 related to opioids.
“It’s a significant problem and it puts substantial pressure on public resources,” he said.
There is no expense to the town – MOLA fronts the litigation cost. If there is a settlement or judgment, MOLA collects a percentage of the settlement and the rest goes to the town.
Selectmen Chairman Dottie Fulginiti said she supported joining the suit to show solidarity with the other communities and to help make change.
“I feel it is very important to stand up for this,” she said.
Selectmen voted 4-0 to sign an agreement to join the suit. Selectman Kevin McIntyre was not present.
In Massachusetts 85 other cities and towns have joined the suit, Sandman said. There are more than 500 involved nationwide.

It could be several years before the lawsuit reaches a conclusion, but Sandman said he would provide updates regularly to the board.

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County: ‘Big Pharma’ lawsuit still ongoing

Apr 11, 2018 | Sun-Gazette (PA)

By Katelyn Hibbard

Suing “Big Pharma” still is on the table, confirmed Lycoming County commissioners Tuesday.
The idea of filing a suit against the pharmaceutical industry in light of the ongoing opioid epidemic first was brought before the public at the start of the new year.
The commissioners gave an update on the matter Tuesday, saying they met with an attorney last week and have submitted information on a potential agreement to the county’s solicitor.
“It sounds like we’re going to go down that road of joining a large group of other counties, cities and states,” said Commissioner Jack McKernan.
“But it’s not class action,” added Commissioner Tony Mussare.
There are 400 cases that have been consolidated in one of the federal courts in Ohio alone, said Commissioner Rick Mirabito.
“Rather than reinventing the wheel and studying all the issues on motions to dismiss, they consolidate them in one district court. It’s an efficiency,” Mirabito said.
“What will occur sometimes is you’ll have individual cases but, rather than having multiple judges to reach decision on them, if they’re similar filings, they’ll consolidate those cases,” said J. Michael Wiley, county solicitor.
In another matter, the commissioners approved an Early Intervention Program contract with the state Department of Community and Economic Development granting the county $82,000.
The commissioners will consider the following items during their next meeting at 10 a.m. on Thursday in Executive Plaza:
• Award $1,500 to the Lycoming County Fire Police Association and $3,000 to the Lycoming Police Camp Cadet Foundation Inc. from the county’s outside agency requests budget.
• Approve VMW licensing and support in the amount of $60,465 from Arraya Solutions.
• Approve a purchase in the amount of $13,891 for two new 2018 Modine heaters with parts from APR Supply Co. for a garage at the county landfill.
• Two personnel actions at the prison.

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Southwest (TX)

County officials just say no to opioid lawsuits

Apr 10, 2018 | SF Texas Record (TX)

By Staff

Remember how self-styled sophisticates howled with laughter when First Lady Nancy Reagan introduced the new slogan for the “War on Drugs” effort back in the 1980s?
“Just Say No” was just so naive – as if children could be expected to resist temptation, the critics stated!
“[D]rug criminals are ingenious,” Mrs. Reagan said in a 1986 televised address to the nation. “They work everyday to plot a new and better way to steal our children’s lives, just as they’ve done by developing this new drug, crack. For every door that we close, they open a new door to death.”
She concluded, “Say yes to your life. And when it comes to drugs and alcohol, just say no.”
Thirty years later, the effectiveness of the “Just Say No” campaign is still debated, but there's no denying that children can say no and stand their ground.
Now might be a good time to revive that much-ridiculed slogan, what with the epidemic of opioid abuse and – in its aftermath – the epidemic of opioid litigation.
County officials can just say no, too, and many of them are doing so, resisting the enticements of plaintiff attorneys peddling opioid lawsuits with visions of huge settlements. Those want-to-be-hired guns can be pretty persistent with their pitches, however, which may mean having to say no multiple times before the dope-suit pushers turn their attention to other prospects.
Last August, Matt Daniel of the Dallas law firm Ferrer Poirot Wansbrough, requested an opportunity to pitch before the Gregg County Commissioners Court “to explain the growing opioid crisis and the way our law firm can help by representing your interests against the distributors who have profited” from opioid abuse.
When his request was rejected, Daniel made an appointment to meet with County Judge Bill Stoudt, which appointment was promptly canceled by Stoudt's executive assistant.
Judges or county officials in Jefferson, Johnson, and Collin Counties have also had to say no repeatedly to similar solicitations.
Here's a hint for all the other pushers out there: No means no.

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Northwest (WA)

County weights joining opioid lawsuit

Apr 10, 2018 | South Whidbey Record (WA)

By Laura Guido

The Board of Island County Commissioners held a round-table discussion last week to consider whether to join multi-district litigation against prescription opioid manufacturers.
The discussion included department heads and staff from Public Health, Human Services, the sheriff’s and prosecutor’s offices and attorneys from the Seattle-based firm Keller Rohrback.
No decision was made at the meeting.
Prosecutor Greg Banks told the group he became interested in the issue after reading a series of articles about the marketing tactics of the prescription manufactures and how their role in changing how pain killers are prescribed and used.
Banks said he learned of Keller Rohrback’s representation of counties and cities in the multi-district litigation and wanted to look into the possibility of Island County getting involved.
“I know that Island County, like any other county, is suffering from the effects of opioid abuse,” he said.
Between 2012 and 2016, Island County had 38 opioid-related deaths, which is a rate of 10.9 per 100,000 population, according to Washington State Department of Health statistics. This rate is higher than the state average of 9.6 during that same time frame.
The national litigation is taking place in Ohio and more than 440 counties and cities have filed joined, said David Ko, from Keller Rohrback. Communities are suing the manufacturers Purdue Pharma LP, Janssen Pharmaceuticals Inc., Endo International Plc and more for their “improper marketing of and inappropriate distribution of various prescription opiate medications into cities, states and towns across the country,” according to the suit.
The number of communities joining the litigation has drawn comparisons to the tobacco litigation of the 1990s. Ko said that as in that settlement, it may prove beneficial to be a part of the suit if a settlement is reached.
“No one really knows how the settlement is going to be structured or shaped, but certainly if you have a seat at the table it’s more likely that you’ll have a say,” he said.
Island County Commissioner Rick Hannold questioned the effectiveness of suing the manufacturers instead of the Department of Justice for not putting anyone in jail thus far.
The multi-district litigation is a civil suit, not criminal, meaning it is seeking monetary damages and not jail time for the defendant.
“If they really want justice, if they really want to do the moral thing that’s right, they’re going to tell the Department of Justice to do their job and enforce the laws that are on the books,” Hannold said.
“In my eyes, it looks like the cities and counties and the states see a pot of money and everybody wants to grab their piece of the pie.”
Banks responded, saying a prosecutor can’t be forced to file charges against someone. Ko said the money being sought is for the costs to communities’ criminal justice system, health care systems and lost productivity from those suffering from addiction.
Commissioner Jill Johnson expressed her skepticism regarding the county’s legal standing in the matter. She said the opioid epidemic was brought forward to the Board of Health and was not designated as a crisis in Island County. She also likened it to other health issues that are driven by misleading advertising, such as obesity.
“We do not sue Coca-Cola,” Johnson said. “We don’t sue McDonald’s. We don’t sue other things where there’s a known cause and effect in their marketing … What about all the people who are getting sick from other lies that are being told?”
She said she wanted to ensure that the manufacturers could be directly identified as responsible for this issue. Additionally, she said she wasn’t sure the problem in Island County could specifically be linked to the prescription medication made by those manufacturers.
“I’m not sure that our population of people got their drugs that way,” she said.
Ko and another attorney from the firm, Dan Mensher, said they felt the county did have solid standing in the case. Ko pointed out that 80 percent of heroin users reported using prescription opioids prior to heroin, which is a statistic cited by the National Institute on Drug Abuse.
“Hamburgers, although delicious, are not Schedule-2 controlled substances,” Mensher replied to Johnson.
Many present verified the effects of the crisis have had an impact locally.
“We’re certainly feeling it,” said Island County Sheriff Mark Brown.
He said in response the department started carrying Narcan, which treats overdoses in emergencies, and he said the jail has begun administering medication-assisted treatment for addiction.
Deputy Rick Felici said he has seen a shift in his time with the department.
“Twenty-four years ago, when I started out as a patrol deputy, we’d never even heard of heroin,” he said. “It was unseen in Island County … Now you can’t swing a cat without hitting somebody that’s affected by heroin in this county.”
During 2017, there were three confirmed heroin-related deaths in Island County, according to state Department of Health data. There were six deaths related to prescription opioids. In 2016, there were 51 hospitalizations related to drugs, but the data on types of drugs was suppressed.
“The numbers are there,” Skye Newkirk, behavioral health coordinator, said at the meeting. He said between 2016 and 2017 the number of people going to the emergency room for overdoses doubled.
Banks said he’s seen the effect both in his work as county prosecutor and on people he knows personally.
“It’s really painful and it just didn’t need to happen,” he said. “It’s wrong. In my view, it was an intentional wrong. If the board’s inclined, I’m certainly in favor of the litigation.”

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Broadcast Media Coverage

FOX 13 News Live at 5:30

Apr 10, 2018 | Salt Lake City, UT

By KTSU (Fox)

Video Link: https://app.criticalmention.com/app/#clip/view/34161505?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
Rough Transcript: the largest county in utah is going after big pharma salt lake county has filed a multimillion dollar lawsuit against opioid drug makers have a lawsuit was filed this morning. fox 13 spend winslow joins us from salt lake city. with more. then in the lawsuit salt lake county is laying hundreds of deaths and millions of dolars in treatment cost at the feet of pharmaceutical giants this morning slowly county filed a civil litigation against multiple pharmaceutical companies salt lake county level it's lawsuit against big pharma marketed and overprescribed addictive drugs. it's led to a health crisis that county leaders allege disproportionately affects the salt lake metro area we average overdose each day in the state of utah over half of those overdoses or right here in salt lake 7:32 PMcounty. so we're its spills out into the streets costing taxpayers milions of dollars are unified police officers every single day. go on and drug overdose overdoses that are in our neighborhoods are impacting not just the person that overdoses but the families.. this is a long lasting impact. we have drug users who had a great life until they becam addicted to opioids it led to drug addiction salt lake county is the latest to sue summit and twitter accounts filed their own lawsuits. and we were in utah counties are threatening litigation it's a short break from utah atorney general sean ray as his approach to join dozens of other states in going after big pharma the state of utah has not led out and we see the harm and devastation that the practice daily basis. we don't have the luxury to wait. we have lives that are being lost in our in our community. some of the pharmaceutical companies being sued did not return our requests for comment but jansen pharmaceuticals issued a statement saying our actions in the marketing labels for prescription opioid pay medicines provide information about the risks and benefits and the allegations made against our company are baseles and unsubstantiated at the utah attorney general's office told me today that liky by the end of this week they will be putting out forbids outside counsel a lawsuit against big pharma the attorney general's office also said that it has been engaged in setlement talks to possibly reac an agreement before a lawsuit is even filed in salt lake city

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2News This Morning at 7A

Apr 11, 2018 | Salt Lake City, UT

By KUTV (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34161557?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
Rough Transcript: the day after salt lake county filed suit against pharmaceutical companies, the issue of opioids will be a hot topic at the state capitol. >> calling in national help we have tiffany justice joing us with what leaders will discuss, tiffany. >> utah does rank towards the top when it comes to drug over doses the round table between state officials and officials 9:34 AMwith the usda will start at 9:00 this morning. we're told, to discuss how opioid abuse is affecting utahans, how to develop affective solutions. we spoke with speaker of the house greg hughes to hear some of his concerns. >> it is unfortunate that we see that the deaths due to abuse, is in utah. it didn't expect income levels, that aren't neighborhoods it stays away from, it is hitting every community. >> now, in attendance will be the usda assistant for the rural development and jim carol from the office of national drug control policy. also in attendance will be utah attorney general shawn reyes, the round table will start at 9:00, wrap up around 11. back to you in the studio. >>> we'll see what happens thanks. 2 news time just about 7:35, salt lake county's new lawsuit against big farma has chronic pain sufferers concerned. >> it is being threatened, i'm really worried about how i will be able to take care of my children now. >> this wasn't really about patient care, it was about profit. >> salt lake county is now suing dozens of pharmaceutical companies as part of a growing trend the crack down on opioid use across the country. the suit claims deceptive marketing as a resulted in salt lake county residents becoming addicted to prescription pain pills causing a major cris in the county. chronic pain sufferers say the lawsuit could impact their ability to function and deal with pain.

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Good Morning Utah

Apr 11, 2018 | Salt Lake City, UT

By KTVX (ABC)

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Rough Transcript: a fight against opiate addiction go to the courtroom. they have filed a lawsuit against manufacturers by the state deceptive marketing meant to opiate addiction and overdose deaths that affect salt lake county. our state about 30 people die from an opioid overdose every month. about half of them happened in salt lake county. >> this cost and suffering, loss of life, destruction of families, enormous burden on taxpayers should not, will not be borne by taxpayers alone. filed a lawsuit against manufacturers. utah and weber counties are planning to do so as well.

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6 News This Morning

Apr 11, 2018 | Lansing, MI

By WLAJ (ABC)

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Rough Transcript: the jackson city council has voted to join the multi-government lawsuit-- holding pharmaceutical companies accountable for their role -- in the opioid crisis. that decision came after a presentation from the sam bernstein law firm -- and discussion by the council. governments around the state - and the nation -- are launching lawsuits against opioid painkiller manufacturers and distributors. they say those companies pushed their products aggressively -- and under-stated their risks-- leading to greater opioid addiction and overdoses around the country in recent years.

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CBS 8 News This Morning

Apr 11, 2018 | Montgomery, AL

By WAKA (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34161421?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
Rough Transcript: the attorney who is filing a lawsuit against opioid manufacturers on behalf of the city of montgomery is speaking out about that lawsuit. the lawsuit alleges the marketing of the drugs contributed to the opioid epidemic, which has caused a financial burden on the city. attorney general jere beasley couldn't give specific numbers but says it has had a major impact. beasley says montgomery ranks in the top 15 cities in the nation with the highest rates of opioid abuse. nationally, he says the crisis has cost taxpayers $500 billion. we asked him about the negative impacts on montgomery. >> it crowds the ergency rooms. you have rehabilitation costs. you have loss of time at work. in fact, people don't realize how many people lose time from work because of this problem. you've got the rehab situation. you've got the law enforcement costs, and it really is has gotten totally out of control. >> andrew: now the beasley allen law firm has filed around 300 lawsuits against opioid manufacturers. companies named in the suit include purdue pharma and johnson and johnson.

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KIRO 7 News 5:00PM

| Seattle, WA

By KIRO (CBS)

Video Link: https://app.criticalmention.com/app/#clip/view/34162698?token=b0f88b7c-b5b7-429f-8d0c-646bcc938110
Rough Transcript: harlan county is the latest to consider joining a lawsuit against opioid makers. they had a roundtable discussion yesterday but have not reached a decision. >>> the state is moving forward with its lawsuit against purdue pharmaceutical. the judge rejected a request to dismiss the case. the company is accused of fueling the opioid epidemic, practicing deceptive marketing and convincing doctors that it treated congress -- treated chronic pain with a low risk of addiction. other similar lawsuits have been filed.

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