A young woman suffering from severe back pain after a car accident was prescribed the opioid OxyContin by her family doctor in 1998. It worked as advertised, allowing her to continue her waitressing job relatively pain-free, until her doctor cut her off after one year. He referred her to a pain clinic, but it didn't accept her insurance. Sick with opioid withdrawal -- chills, vomiting, and flu-like symptoms -- she became desperate and was introduced to heroin.
It also worked, but she needed a stronger dose after a few months and began injecting the illicit drug (which is nearly identical to the active ingredient in OxyContin). This led to years of addiction and squalor until she finally got the help she needed.
Hers is just one story among thousands that often end in tragedy. America's opioid crisis, the deadliest drug overdose crisis in U.S. history, is linked to the overprescription of OxyContin and similar drugs and has triggered a wave of opioid lawsuits. This article focuses on legal actions against manufacturers, distributors, and other suspected culprits of the crisis.
Opioids: The Basics
The term "opioid" refers to a broad class of drugs that includes poppy-derived opiates such as morphine and heroin, as well as synthetic opiates such as fentanyl, oxycodone, and hydrocodone. The latter two substances, commonly prescribed for the management of chronic and acute pain, are the subject of opioid lawsuits.
Several pharmaceutical companies manufacture these drugs, including Teva Pharmaceuticals, Johnson & Johnson, and -- most notably -- Purdue Pharma (which introduced OxyContin in 1996). Other prominent brand names include Vicodin and Percocet. Drug makers marketed these substances as safe and not prone to abuse, often touting protective coatings that allow for time-released dosage.
However, patients who became addicted (and others using them illicitly) would simply suck the coating off the pills, crush them into a powder, and either snort or inject the often-massive (and "high"-inducing) opioid dose. Also, as illustrated above, many patients remained addicted after their prescriptions ran out, often leading to the abuse of heroin, fentanyl, or other illicit opioids.
Federal, Tribal, State, and Local Opioid Lawsuits
As state resources became stressed due to skyrocketing addiction rates and overdoses, many states (as well as the Cherokee Nation, other Native American tribes, counties, and cities) filed lawsuits against opioid manufacturers and distributors. The growing list of states filing lawsuits includes Ohio (which was particularly hard-hit by the epidemic), Mississippi, Oklahoma, Missouri, New Hampshire, Texas, Florida, Nevada, North Carolina, North Dakota, and Tennessee.
These complaints were consolidated into a lawsuit filed in Federal District Court in Cleveland, Ohio in December 2017. Plaintiffs in the suit allege the following, stating that they contributed to the current opioid epidemic:
- Manufacturers of prescription opioid medications overstated the benefits and downplayed the risks of the use of their opioids and aggressively marketed (directly and through key opinion leaders) these drugs to physicians; and
- Distributors failed to monitor, detect, investigate, refuse, and report suspicious orders of prescription opiates.
In a 2018 statement, U.S. Attorney General Jeff Sessions cited estimates of 64,000 overdose-related deaths in 2016 and estimated the crisis has cost the federal government as much as $1 trillion since 2001. Furthermore, he estimated that it could cost the United States an additional $500 billion between 2018 and 2021.
Opioid Lawsuits: Legal Arguments
The allegations in the consolidated federal case listed above are fairly consistent among the more than 400 opioid lawsuits filed by Native American tribes, states, counties, and cities. The two main legal arguments target opioid manufacturers and distributors.
1. False Advertising and Marketing
Similar to state and federal claims against Big Tobacco in the 1990s, plaintiffs claim that Purdue Pharma and other prescription opioid manufacturers either knew or should have known that their products were prone to abuse and addiction. Plaintiffs point to numerous documents and online resources directed to both physicians and patients claiming that opioid addiction is a "myth" and that opioids were necessary because pain was undertreated.
In its May 31, 2017 complaint against Purdue Pharma and other opioid manufacturers, Ohio Attorney General Mike DeWine claimed that the defendant "spent, and continues to spend, millions of dollars on promotional activities and materials that falsely deny or trivialize the risks of opioids while overstating the benefits of using them for chronic pain."
In fact, opioid manufacturers regularly cited a 1980 letter to the editor of the New England Journal of Medicine claiming that addiction is rare in patients treated with narcotics. This wasn't a peer-reviewed study, but merely a letter that its author now regrets writing.
2. Failure to Monitor Distribution
Federal and some state laws require distributors of controlled substances (such as opioids) to prevent misuse and abuse of the system. The so-called "diversion theory" argues that distributors should have known something wasn't quite right just by the sheer volume of prescriptions being filled. Plaintiffs claim that distributors simply looked the other way, blinded by record profits.
For example, an investigation by the Charleston Gazette-Mail discovered that roughly 9 million hydrocodone pills flooded into a single pharmacy in the small town of Kermit, West Virginia (population 393) in just two years. Many of these pharmacies and pain clinics have been described as "pill mills" for their allegedly loose prescribing of pain medications.
The lawsuit by the Cherokee Nation was the first to go after the distributors, including McKesson Corp., Cardinal Health, CVS, Walgreens, and Walmart. The complaint provides numbers for context, amounting to the distribution of roughly 360 pills for each opioid prescription in the 14-county Cherokee Nation.
Need More Information About Opioid Lawsuits? Talk to an Attorney
The federal lawsuit, along with some plaintiffs that decided not to join the larger action, are targeting manufacturers and distributors in hopes of a larger settlement. But if you or a loved one have suffered as a result of the negligence of a prescribing doctor or other party, you still have options. Talk to a health care attorney today and get some peace of mind.