In federal court, Oklahoma vs. opiates

Jul 21 2017

In federal court, Oklahoma vs. opiates

 

As in many states, the epidemic of opiate addiction has been a major problem in Oklahoma. Now, the Sooner state is involved in not one, but two, major lawsuits against companies that manufacture, distribute and sell opiate painkillers.

In late June, Oklahoma Attorney General Mike Hunter filed a lawsuit in Cleveland County District Court against Purdue Pharma LP, Johnson & Johnson, Allergan Plc and units of Teva Pharmaceutical Industries Ltd.

The drugmakers engaged in a “fraudulent, decades-long marketing campaign to profit from the suffering of thousands of Oklahomans,” Hunter said in a statement. “The lawsuit claims the companies knowingly marketed their drugs as safe for chronic pain management while downplaying the risk of opioid dependency,” he added.

The lawsuit does not specify the dollar amount the state will be asking the drug companies to pay, but Hunter indicated it could be in the “billions of dollars,” according to NewsOK.com.

The other Oklahoma-based lawsuit was filed in April by The Cherokee Nation, which is suing major drug distributors and pharmacies, alleging they profited by “flooding” communities in Oklahoma with prescription painkillers, leading to the deaths of hundreds of tribal members. The lawsuit estimates opioid abuse led to over 350 deaths within the Cherokee Nation between 2003 and 2014.

Todd Hembree, attorney general for the Cherokee Nation, says drug companies should have done more to stop overprescribing of opioid painkillers such as OxyContin and Vicodin, and didn’t do enough to keep painkillers off the black market. “They flooded this market,” Hembree says. “And they knew — or should’ve known — that they were doing so.”

Purdue, which makes OxyContin, said it denies the allegations but shares Hunter’s concerns about the epidemic. J&J said it acted appropriately, adding that its opioid medications carry U.S. Food and Drug Administration-mandated warnings about their risks. Allergan said it supports the safe, responsible use of prescription medications. Teva said it is committed to the appropriate promotion and use of opioids.

Oklahoma’s lawsuit followed similar cases brought against some of the same companies by Mississippi, Ohio and Missouri. Several cities and counties in California, Illinois, Ohio, Tennessee and New York have also filed lawsuits over companies’ marketing of opioids.

The Cherokee Nation suit names Walgreens, CVS Health and Wal-Mart, along with the nation’s three largest pharmaceutical distributors: AmerisourceBergen, McKesson and Cardinal Health. They distribute 85 to 90 percent of the prescription painkillers sold in the U.S., according to National Public Radio.

One of the defendants, Cardinal Health, told NPR the suit was a mischaracterization of facts and a misunderstanding of the law. “We believe these lawsuits do not advance the hard work needed to solve the opioid abuse crisis — an epidemic driven by addiction, demand and the diversion of medications for illegitimate use.”

But the Cherokee Tribe says these companies regularly filled large, suspicious prescriptions within the Cherokee Nation’s 14 counties in northeastern Oklahoma. It also says the companies failed to screen patients who doctor-shopped and presented multiple prescriptions for the same medication.

Oklahoma, where 177,000 tribal members live, leads the nation in opioid abuse. Almost a third of the prescription painkillers distributed in that state went to the Cherokee Nation.

“There are safeguards that are supposed to be followed — federal laws — that they turn a blind eye to because their profits are much more important to them,” Hembree says. “We were being [overrun] by the amount of opioids being pushed into the Cherokee Nation.”

A spokesperson for Walgreens told NPR the company declines to comment on pending litigation. CVS Health said in a statement, “We have stringent policies, procedures and tools to ensure that our pharmacists properly exercise their corresponding responsibility to determine whether a controlled substance prescription was issued for a legitimate medical purpose before filling it.” The other companies did not immediately respond to requests for comment.

Compared with other racial and ethnic groups in the U.S., Native Americans have the highest rate of drug-induced deaths in the country, according to the CDC. The use of OxyContin by Native American high-schoolers is double the national average.

A number of Cherokee babies have been born with an opioid addiction resulting from their mothers’ use of prescription painkillers throughout the pregnancy, NPR reported. Some spend their first moments on earth suffering through withdrawals.

“They will have shakes, they will cry, and a lot of these children go on to have developmental and cognitive issues,” Nikki Baker-Limore, executive director of child welfare for the Cherokee Nation, says. “These children are born and they don’t even have a chance the second they come out of the womb.”

Cherokee Nation claims in the suit that drug companies are making money off a vulnerable population and ignoring epidemiological and demographic facts. It is the first time a Native American Nation has sued top drug distributors and pharmacies, according to NPR.

Meanwhile, a report issued by the Centers for Disease Control included some good news for Oklahoma. In the report issued on July 6, the CDC found that 32 of Oklahoma’s 77 counties, including Oklahoma County, saw decreases in the number of opioids prescribed from 2010-2015. In 12 other counties, prescriptions were stable. (No information was available for 15 counties.)

In 18 counties, however, opioid prescriptions increased during the same five-year period. This included a cluster of nine counties in far eastern Oklahoma.