In the next two years, the opioid epidemic is estimated to cost the United States a trillion dollars and kill almost 100,000 Americans. President Donald Trump declared it a public health crisis this year but has not asked Congress for additional money to fight the scourge.
That leaves states, counties, and cities to bear much of the cost—and they want Big Pharma to pay.
“We kept seeing our crime problems and overdose deaths going up every year, and we got no response for anyone with the federal government,” Mayor Paul Billups of Ceredo, West Virginia, told The Daily Beast. “They didn’t have a plan, so we decided to come up with a plan. We decided caring for people is more important than marketing and profits.”
Ceredo is one of about 250 states, counties, and cities that have filed lawsuits against multiple pharmaceutical companies and distributors of opioid prescription pills that are blamed for turning pain patients into heroin addicts.
Richie Webber is one such victim. A star high-school track and football athlete 10 years ago, Webber got injured, got on pain pills, and got hooked. It led to heroin use and two nearly fatal overdoses. Webber has been clean for about three years and works with a community group in his native Ohio to help people like him get treatment.
“I find it really odd when the pharmaceutical companies that make pills like OxyContin claim they are nonaddictive and just help people with pain,” he said. “Well, let’s look at it from my perspective. We’ve helped more than 300 people get into rehab this year, and 90 percent of them started with prescription pain pills. That’s nonaddictive?”
That is the thrust of most of the lawsuits: Those who make and distribute opioid pain pills have to clean up the drug addiction mess, and that mess was created by deceptive marketing and claims that these pain meds were nonaddictive. Communities want the companies they’re suing to help pay for “significant harm and damages, including, but not limited to, the breakdown of families, increased health insurance costs, increased police and fire usage, increased usage of the criminal justice system and other significant harms,” as a recent lawsuit filed Columbus, Ohio, put it.
These lawsuits are being filed all over the country, from Seattle, Washington, to Bangor, Maine. The Cherokee Nation has filed one as well.
“All we are looking for is a little justice in all this,” Pete Orput, the Washington County attorney in Minnesota told The Daily Beast on why his county joined other counties in the state filing suit. “We just want some payback. For years we have heard [the pharmaceutical companies] tell us they have nothing to do with the addiction. I resent what they have told us, and I resent what they have done in our community.”
The defendant named in most lawsuits is Purdue Pharma, which introduced OxyContin in 1996. The drug is a pain medicine based on a morphine-like derivative that Purdue promised was nonaddictive thanks to its time-release formula. Originally, it was prescribed for acute pain, like broken bones, terminal cancer, or post-surgical recovery. By the 2000s though, it was doled out by doctors to treat chronic and even minor pain.
“What happened was compassion became conflated with opioid prescribing, so a doctor who wasn’t willing to prescribe opioids was seen as withholding and sadistic,” said Anna Lembke, a professor of psychiatry and behavioral sciences and author of Drug Dealer MD: How Doctors Were Duped, Patients Got Hooked and Why It’s So Hard to Stop.
In a statement, Purdue Pharma said: “We are deeply troubled by the prescription and illicit opioid abuse crisis, and 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… We vigorously deny these allegations and look forward to the opportunity to present our defense.”
Opioid prescriptions tripled between 1999 and 2016 and so too did overdose deaths. In 2016, 42,249 people in the U.S. died of opioid-caused overdoses, according to the Centers for Disease Control and Prevention—more than deaths from breast cancer that same year. The White House Council of Economic Advisers (CEA) last November estimated the cost from the opioid crisis was about $500 billion in 2015.
Back to Big Tobacco
Supporters and critics of the opioid lawsuits point to the lawsuits by states against tobacco companies in the 1990s for the cigarette-makers responsibility for health problems like lung cancer. That was settled in 1998 for $246 billion, and the tobacco companies will pay their yearly allowance of that settlement through 2025.
“The model for this is still tobacco,” said David Kessler, who led the Food and Drug Administration from 1990 to 1997 and pushed hard for the FDA to regulate cigarettes. “Those who sell or distribute these highly addictive products need to have systems in place that they adhere to so we can control this epidemic.
“It is accepted and there is little doubt that too many of these drugs were put into the marketplace and sold beyond their legitimate needs,” Kessler told The Daily Beast. “The vast majority of people get addicted because of prescriptions, and we need to tighten the distribution and make the manufacturers of these drugs more responsible for what they have placed in the market.
“This is a public health issue, and we need to get better control on how much of the drug is placed in the market. These lawsuits may call better attention to those goals.”
Pharmaceutical companies in the past have settled lawsuits like these (including Purdue Pharma) and treat their fines as a cost of doing business. In this case, however, the settlement might be very big. “There is power in numbers,” says Orput. “You can pay one or two of us off, but you can’t pay all of us off.”
If Big Pharma is forced to pay, the question is to whom and how many. Treatment services? Increased foster care for children of addicts? Compensation to the addicts themselves?
Just the amount of funding that might go to the families of the deceased could be huge. From 1999 to 2015, more than 183,000 people have died in the U.S. from overdoses related to prescription opioids. If the court valued those lives at $50,000 each (to pick a random number), that would be $9 billion just in death payments.
Kenneth Feinberg, the attorney who oversaw the Sept. 11 victim’s fund dispersal, as well as similar appointed jobs with the BP offshore oil cleanup and the Boston Marathon bombing, said any settlement would need to be combined with congressionally approved funding to “have a better idea of who to and how much is distributed.”
“But getting anything through Congress is a chore,” Feinberg said. “If Congress enacted and appropriated enough money to deal with this crisis, a lot of these lawsuits would disappear.”
Wayne Campbell of Pickerington, Ohio, has been hearing the calls from other parents for the federal government to do something since his son, Tyler, died from a heroin overdose in 2011 after he was prescribed pain medication for a football injury.
“We constructed a timeline of his death, and it was just 18 months from precipitation drugs like OxyContin to heroin to rehab treatment to overdose and death,” he says of his son.
Campbell now runs a nonprofit group called Tyler’s Light, which tries to raise awareness about drug abuse and addiction for Ohio schoolchildren.
“If you see dead fish floating in the river, the best thing to do is to go upstream and find out why the fish are being killed. I think these lawsuits might have a role in us as a society doing that.”