County suit against drug firms alleges marketing caused crisis

The Washington County government has joined in filing a lawsuit against numerous drug companies alleging that their marketing of opioid painkillers created an epidemic that has led to more than a death a day in Maine and cost the county millions of dollars. The Washington County commissioners recently voted to file suit, along with numerous other counties and municipalities in the state, as part of a nationwide effort that includes more than 1,600 lawsuits against OxyContin maker Purdue Pharma that are consolidated in an Ohio federal court. The county's suit also names nearly 20 other drug manufacturers, plus drug store chains CVS, Walgreens, Wal-Mart and Rite Aid.
The lawsuit alleges that the drug companies "put their desire for profits above the health and well-being of Washington County's residents," that they knew that opioid painkillers like OxyContin and Percocet were addictive and subject to abuse, particularly when used for chronic pain, and that they used "a sophisticated and highly deceptive and unfair marketing campaign" that misrepresented the risks and benefits of the opioids. Their efforts, the suit notes, were "wildly successful," with healthcare providers in 2012 writing enough prescriptions for opioid painkillers "to medicate every adult in America around the clock for a month. Twenty percent of all doctors' visits in 2010 resulted in the prescription of an opioid, nearly double the rate in 2000." Americans consume 80% of the opioids supplied around the world, and they generated $8 billion in revenue for drug companies in 2012.
According to the suit, as a result of the opioid and eventual heroin epidemic more than 17,000 Americans died from prescription opioids in 2015. "More Americans have died from opioid overdoses than from participation in the Vietnam War." In Maine, drug overdose deaths have averaged more than one a day in recent years, with Washington County having the highest per-capita rate in the state between 2012 and 2014 and the second highest rate of drug-affected babies. However, the suit notes, "Death statistics represent only the tip of the iceberg. According to 2009 data, for every overdose death that year, there were nine abuse treatment admissions, 30 emergency department visits for opioid abuse or misuse, 118 people with abuse or addiction problems, and 795 non-medical users." The suit also notes that many prescription opioid addicts migrate to heroin, since it is cheaper. Referring to 3,000 heroin overdose deaths in the U.S. in 2010, the suit notes, "Nearly 80% of those who used heroin in the past year had previously abused prescription opioids."
To combat the epidemic, the county has been required each year to spend millions of dollars, which includes healthcare costs, criminal justice and victimization costs, social costs and lost productivity costs.
"Something has to be done," county commission Chair Chris Gardner comments. He asks rhetorically, "How many pills have been prescribed per capita in Washington County and the state? It doesn't pass the straight face test. There's at least some malfeasance in the industry -- doctors included -- for something so destructive to become so mainstream."
From the county's standpoint, although funding is needed on the educational and treatment aspects of dealing with addiction, the costs are mostly associated with law enforcement. "It's filling up our jails," says Gardner. "The amount of money it's costing local taxpayers because of more people in jail for drug-related offenses." Noting that those who are arrested for substance use crimes are more likely to be in poor health and also may require treatment services, Gardner says there's been a spike in costs to the county. He notes that the county budget battles during the past two years were caused by adding more deputies to combat the drug problem.
"Any money we recoup will be used to offset those costs," says Gardner. "The interdiction piece is where we fit into the puzzle."
Gardner predicts that the outcome of the suit will "come down to public pressure on the pharmaceutical companies. "Do they want to litigate or settle this? I don't think they really want to take this to court." If a settlement agreement is reached, the case could be resolved more quickly, Gardner notes.
In its response to a lawsuit filed by the Massachusetts attorney general, Purdue Pharma asks for the suit to be dismissed, calling it "an oversimplified scapegoating based on a distorted account of the facts," according to news reports. The drug manufacturer has argued that the U.S. Food and Drug Administration approved labels for its opioids that carry warnings about the risk of abuse and misuse of the pain medications. According to Reuters, the company is exploring filing for bankruptcy to address the potential liabilities from all of the lawsuits. It also has held discussions with the attorneys filing the suits to reach a settlement.