Drug distributors advocate in West Virginia opioid trial
After just five days of testimony, attorneys representing the nation’s three largest drug distributors have rested their defense in the landmark opioid lawsuit in West Virginia federal court.
After attempting to blame several other parties, from drug makers to doctors prescribing bills, the distributors’ latest expert witness questioned the nature of a supposed opioid epidemic.
Stephenie Colston, who has professionally managed treatment programs and oversaw the distribution of federal funds to state and local governments to fight opioid and substance-related disorders, argued that instead of an individual opioid crisis , the country has long faced “a series of evolving crises.” from drug to drug. Colston cited recent data from the West Virginia Department of Health and Human Resources showing a slight increase in methamphetamine overdoses to prove his point.
“Pointing the finger at any of these substances is not quite what I consider accurate,” she said.
But when Huntington’s attorney Paul Farrell asked Colston if the multi-drug abuse problem was significantly interfering with public health in Cabell County, she replied, âAbsolutely.
Colston’s testimony went further than previous defense witnesses, who echoed the companies’ argument that doctors sparked the drug crisis because they prescribed too many painkillers.
Cabell County Commission and Town of Huntington Sue “Big Three” prescription drug distributors – McKesson, Cardinal Health and AmerisourceBergen – alleging they fueled the opioid epidemic by flooding the region with strong painkillers such as OxyContin.
But distributors’ witnesses testified that a huge spike in opioid prescriptions started and fueled the crisis. They say demand has boosted supply: the number of pain pills prescribed matches the number of pills dispensed by pharmacies and shipped by distributors.
Distributors called in witnesses who said the increase in opioid prescriptions in the late 1990s and 2000s followed a nationwide change in the “standard of care” for the drug. treatment of people with pain. Doctors were encouraged to prescribe pain relievers by Purdue Pharma, the makers of OxyContin.
“Many doctors have adopted the philosophy that you increase the dose of opioids until someone is better,” said Dr. Tim Deer, a Charleston-based pain specialist who testified on behalf of the distributors during the test last week. “And there was no cap.”
In the late 1990s, Deer was paid by Purdue Pharma to speak at events across the state including Charleston and Huntington, he acknowledged during his testimony. At the time, Purdue was marketing OxyContin as a non-addictive drug to treat patients with chronic pain. Deer said he received up to $ 1,000 for each conference, but did not use the company’s promotional materials during his presentations.
âIt was a bit of a problem with them,â he said.
Deer said he severed ties with Purdue several years later after some of the drugmaker’s other stakeholders said it was safe to prescribe OxyContin to alcoholics.
âI felt it was totally crazy,â Deer said. “Every piece of information says it’s wrong.”
But that hasn’t stopped others from jumping on the painkiller bandwagon, even groups supposed to protect the health of patients.
The West Virginia Medical Council, which licenses physicians, issued policy statements in 1997, 2005, and 2013 that supported prescribing opioids and ordering physicians to aggressively treat pain – and told them to assured that they would not be sanctioned if they did. In 2008, the council also sent copies of a book to doctors across the state that recommended using prescription opioids as the first and best option for patients with chronic pain.
Throughout the trial, attorneys representing Huntington and Cabell County said the oversupply of prescription opioids led to the painkillers being diverted to the black market, leading to an increase in drug overdose deaths. . West Virginia has the highest fatal overdose rate in the country.
Drug distributors presented witnesses who testified that once pain relievers are prescribed by doctors and dispensed by pharmacies, companies no longer have control over them.
City and county attorneys allege people addicted to prescription opioids switched to heroin use a decade ago after state began cracking down on so-called pain management clinics and state legislators have adopted measures to reduce pain medication prescriptions.
Lawyers for drug wholesalers dispute the idea that prescription pain relievers were used as a gateway to heroin use. Company lawyers have also repeatedly argued that distributors are too far removed from opioid abuse to be held accountable.
“[Cabell County and Huntington] say that abuse leads to subsequent use of illegal drugs, âsaid Tim Hester, who represents McKesson. âWell, it involves a crime of prescription opioid abuse followed by a crime of drug trafficking followed by a crime of drug trafficking followed by a crime involving drug buyers, drug users, intravenous drug users and others who acquire the drugs illegally. “
The defense has also tried to argue that Cabell and Huntington County are suing distributors for huge sums, while West Virginia holds millions of unspent federal dollars meant to curb the opioid crisis. According to a 2020 report released by the Office of the Inspector General of the US Department of Health and Human Services, West Virginia spent only 34% of the $ 12 million it was awarded by DHHS in 2018 and 2019 – a lower percentage than any other state.
Lawyers for both sides will return to the Charleston federal courtroom on July 27 to deliver argument. U.S. District Judge David Faber is expected to decide the case in the coming weeks.